P&S Journal: Spring 1997, Vol.17, No.2
The Human Portrait of Breast Cancer
Today, Ellen Stein looks like a healthy and energetic woman in her prime--with no visible signs of what she's been through physically or emotionally. Almost three years ago, however, things were less positive for the middle-school gym teacher when she discovered a breast lump during a family vacation. "I didn't say anything at first, but then the lump started to change: It got bigger then smaller, and I had pain down my arm."
After a misdiagnosis, surgery, then a correct diagnosis--all by providers not affiliated with CPMC--Ms. Stein wasn't about to take any chances. She ended up choosing two medical oncologists, but somewhat inadvertently. After Ms. Stein and her husband investigated oncology programs throughout the United States and educated themselves about treatment options, they decided on CPMC's program. Yet Ms. Stein still wasn't sure about that choice because treatment at CPMC would require a trip from her home on Long Island to northern Manhattan. "Me, in my infinite wisdom, thought 'I'm not going there--it's in the city, it's geographically undesirable.'" But then she had a second thought: Wouldn't she be required to stay in isolation during her stem cell transplant? If so, being far from home would only help, she thought, since her family wouldn't be able to visit anyway. "I consented very reluctantly to have this consultation."
From the beginning, both Ms. Stein and her husband liked Dr. Linda Vahdat, a medical oncologist in the breast cancer center and assistant professor of clinical medicine. "And I don't know where I'd be without her," says Ms. Stein. "She was the first to say 'This is what needs to be done: You'll need chemotherapy, you'll need a stem cell transplant, you'll need radiation.' Most doctors I'd been to would only tell you bits as if they didn't think you could handle the truth all at once. She told it all."
Ms. Stein's chemotherapy treatment was at a facility near her home. "I kept a diary after each treatment," she says. "For example, I'd write 'Treatment One: went to the diner afterward.' Later I wrote that I'd have chills or a little nausea, and then finally, 'I feel like me.' It was helpful to refer back to my notes after other treatments, because I'd confirm that I did feel the same after earlier treatments."
Her chemotherapy was followed by a 19-day stay at Presbyterian Hospital for an autologous stem cell transplant. "The first two and a half days I thought it was going to be a piece of cake, but then it got bad." Ms. Stein tells of feeling very sick with pain and terrible stomach upset. She couldn't eat a thing and became very weak. "There wasn't a nurse, a doctor, or attending who was not warm and incredible," she says.
One ironically pleasant surprise, however, was that Ms. Stein's family could visit her in the hospital. "I discovered that isolation [to avoid contact with outside germs and potential infection] means you're not allowed out, but you are allowed visitors."
Once the stem cell transplant was complete, Ms. Stein was terribly weak but thankful to have made it through. She was also able to keep a promise. "Before the transplant, I promised my sixth graders that I'd be back to school for their graduation." She was able to return to work the week before commencement.
Ms. Stein is now in the follow-up stage of her breast cancer treatment. "My last exam will be in 2002," she says. "Every birthday looks a little better."
In addition to crediting her husband and family, Ms. Stein credits Dr. Vahdat and the chemotherapy and stem cell transplant nurses with getting her through her treatment. "For all the brilliance, all the professionalism, and all the care--it was the care that was the most important," says Ms. Stein. "They make an otherwise horrible experience tolerable."
Ellen Stein and family
Middle-school gym teacher Ellen Stein, who tends to look on the bright side, is a grateful beneficiary of ongoing advances in breast cancer treatment. "After all the consultations I had, I thought how fortunate I was to be diagnosed now and not five years ago," she says.