A Conversation With Dr. Maria Theodoulou, associate attending physician on breast cancer medical service at Memorial Sloan-Kettering Cancer Center in Manhattan. Dr. Theodoulou will be the keynote speaker at the Cancer Care of the East End sponsored forum “Conversations about Breast Cancer: Update on Medical Treatment, Side Effects, and Psychosocial Issues” at the Bridgehampton Union Free School District auditorium on Saturday, October 18.
How did your career find its focus in oncology and specifically, breast cancer care?
It’s actually a pretty straightforward story. First off, I was older when I started my formal education. I had always been interested in natural sciences and biology and I was actually sent by one of my professors at Fordham University to volunteer at Memorial Sloan-Kettering to see if I was comfortable with oncology services … It was interesting because I got to meet women with breast cancer, some who were dying, although this was all the way back in 1981.
What I found was that breast cancer is a disease with a title, but also is a disease with a number of psychological and social issues attached to it … With breast cancer, there is a constant reminder left behind no matter how pristine the surgery. Also, the sexual connotations were so huge during a time where people did not really talk about the disease.
Two weeks before medical school I actually would up needing a biopsy myself … I didn’t know what would happen, although fortunately it was benign. But at the time you didn’t know if you went into an appointment whether you would come out without your breast. I told my daughter the night before I was going to the hospital that I might come home without a breast, and only a six-year-old could say this, but she said, “Don’t worry mom. No one will really notice.”
So that is when it really began to cement with me … [In school] I was assigned to a medical oncologist, without anyone knowing the whole field of oncology and breast cancer had become fascinating to me. And on my first day, I went in to meet a patient and it was fascinating because it was a woman in her 70s coming in for a seven-year follow up appointment.
The same afternoon, I met a 32-year-old … we were addressing end of life with her. That was it for me. I kept thinking breast cancer is not one disease. My patients really do teach me every day.
How did you get involved with Cancer Care of the East End and this Saturday’s event?
Well, actually, the director of Cancer Care [Theodora Ziongas] is someone I know personally. She was a social worker and a prominent figure in caring, from a psychological perspective, with supportive measures for many of the patients who came to Memorial [Sloan-Kettering] … I have watched her career just grow and grow over the years and she has been doing just great work with Cancer Care. We got together to talk about the event, and before she even asked, I said yes. I try to do a lot of advocacy, teaching and presenting, not only in October [Breast Cancer Awareness Month], but also year round.
How has the prognosis changed for women who are diagnosed today as opposed to 10 years go?
Number one, we are diagnosing early on and less women are dying from it. In the first 15 years of my practice I can honestly say I was going to a lot of funerals. Now I go to one every few years. What has happened is the disease is now out of the closet, people are talking, we are having events like the one this Saturday, advocacy movements are just exploding, celebrities are sharing their stories … Women are more empowered and proactive and have become smarter in understanding breast cancer is not just one disease.
We also have much smarter people than I doing very important lab work developing treatments so we are able to treat women in early and advanced settings. Women are living longer now, even when the cancer has become metastatic. Even if the disease does not go away, now, using the art of medicine, not just the science, and understanding the host – their strengths, their weaknesses, their physical, emotional and psychological state, we can usually treat patients with targeted therapies that are much more effective.
You have a particular interest in the psychological and emotional impact on patients and their families. What advancement have you seen in your career in the support systems available for those battling breast cancer, or their loved ones?
Number one, and I think the most important thing, is women are talking about it; which creates a global support system. And a dialogue has developed that has really reached across the world.
Knowing you are not alone, not singled out, and being able to share information and questions is vitally important. For me this is the biggest thing … Clearly the psychological impact can be huge. Successful plastic surgery has made outstanding changes, but the patient always knows when it is a reconstructed breast, whether it is a little scar only they can see in the shower or decreased sensation in an area, there is always a reminder.
We really focus on individual patients and their strengths, whether it be home nesting – cooking, caring for families – or blue collar, white collar work environment. Regardless of who they are, covering the whole gamut of individuals out there, we work on developing those strengths to make sure those women are still those women after their diagnosis and treatment … and we are really finding ways to address the sexual issues that arise, whether it be how one views themselves, or from their partners’ perspective.
We certainly have now not just support systems, but integrated support systems where complimentary therapies or “look good, feel good,” address the physical issues moving forward. It’s amazing the wealth of support that there is available to be able to build up tools, but it is a matter of knowing who is there, what is available.
What is the future for the fight against breast cancer, in your professional opinion?
I am looking forward to being out of a job. That will be a great day – the day I no longer have work. I wake up every morning thinking, when will we come up with the cure? I know we are getting better and better, I know there are earlier diagnoses, less deaths, people are living longer. Will it happen in my lifetime? I don’t know, but I think we are getting there.
I am a great cook. I think I will open a great restaurant when I am finally out of a job.
“Conversations about Breast Cancer: Update on Medical Treatment, Side Effects, and Psychosocial Issues” will be held at the Bridgehampton Union Free School District auditorium on Saturday, October 18 from 10 a.m. to 2:30 p.m. and is free for members of the public. The event is sponsored by Cancer Care of the East End in cooperation with Southampton Hospital.