Be aware, not afraid, advises nurse practitioner
Cancer survivor who works at Kaiser’s breast care center says anxiety about disease is high
Kaiser Permanente's Breast Care Center nurse practitioner Paula Kelleher works with long-time patient and fellow Kaiser Permanente nurse Sandie Wasko for a follow-up exam after Wasko had a mammogram.
Crista Jeremiason / The Press DemocratPublished: Saturday, October 24, 2009 at 10:21 a.m.
Last Modified: Saturday, October 24, 2009 at 10:21 a.m.
Nurse practitioner Paula Kelleher gets to deliver a lot of good news about breast cancer at the Breast Care Center at Kaiser Permanente in Santa Rosa.
In fact, she gives out more good news than bad, which might be surprising since her patients come in dreading the worst, their worry level ranging from “some anxiety all the way too literally terrified and making out their will.”
This fear concerns Kelleher because even with advances in diagnosis and treatment of the disease, more political advocacy for research and a huge boost in public awareness in recent years, she sees “a greater level of anxiety in women.”
Ironically, she thinks much of it stems from that increased awareness. Public attention on breast cancer really got going in the early 1990s. It moved politicians and policy makers to make it a funding priority. It motivated women to do self exams and get mammograms. It got front-page and nightly news play by the media.
The flip side to all that, said Kelleher, is that women started thinking, “Oh my God, I’m going to get it, too.”
Yet she can report that the vast majority of women who come to see her do not have breast cancer. That’s a lot of relieved women, considering that Kelleher sees an average 12 women a day who come into her exam room worried about a lump, a pain, a family history, a questionable mammogram or because their physician wants further evaluation.
Kelleher has always worked in women’s health, first as a nurse and for 23 years as a nurse practitioner. She remembers when breast cancer was a shameful secret diagnosis, before pink ribbons, a dedicated month and fund-raising marathons.
Today, “with breast cancer the most commonly diagnosed cancer in women, combined with the media and pink everything, women are aware. I just wish they didn’t have to be so afraid,” she said.
“(Author) Susan Love talks about women thinking of breasts as the loaded guns on your chest,” she added, referring to Dr. Susan Love, the noted author, surgeon and breast cancer activist.
To counter that kind of thinking, Kelleher tells patients, “Love your breasts. Don’t fear them. They’re probably okay. And even if they get diseased, we’ll deal with it.”
Kelleher is not being Pollyanna about what she knows is “a very real and devastating disease.” But she adds, “Sometimes it’s spun like it’s an inevitability.”
She thinks one reason middle-aged women start thinking that breast cancer is coming to get them is because Baby Boomers are now in the age group, 50 and up, that is a risk factor for breast cancer.
“There’s more of us,” said Kelleher, 55. “We see the neighbor, a relative, a friend getting breast cancer and that probably has most to do with so many of us being in that age group.”
Yet even women of that age group can relax a little, says Kelleher. If there are no other risk factors, women have a 98 percent chance of getting through their 50s without breast cancer.
“I tell patients that they could go to Vegas with those odds.”
Her good news about breast cancer doesn’t just come from being a professional. Kelleher herself had breast cancer. So did her mother, great aunt and a sister.
“And we’re all alive,” says Kelleher, showing a family photo with her 85-year-old aunt diagnosed when she was 35, her sister, diagnosed at 52 and her mother, diagnosed at 60. Kelleher was diagnosed at age 38.
When her sister was diagnosed, Kelleher’s daughter told her, “Don’t worry. You’ll get over it just like mom and grandma did.”
As for dreading cancer, Kelleher was the opposite of the worried women she counsels.
“Even with my mother and my aunt, when I felt a lump I didn’t think cancer. I thought it was probably a benign tumor. I was shocked” to hear it was cancer,” she said.
She had a lumpectomy and radiation and has had no recurrence in 17 years.
She did what she tells her patients who are diagnosed with it. “Get it treated and go back to enjoying life.”
Susan Swartz is a freelance writer and author based in Sonoma County. Contact her at susan@juicytomatoes.com.
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