Coping with the Elephant in the Room Gynecologic Oncologist Helps Patients Deal with the ‘C Word’

Dr. Tashanna Myers says that when you work as a cancer specialist, a big part of your job is in education.

And that’s good, because she considers this to be one of her major strengths. That and communication, in all its many forms, which is also quite important when you’re a gynelogic oncologist.

“I’m always the one who speaks about the ‘big C’, the elephant in the room,” said Myers, who joined the Baystate Regional Cancer Program’s Gynecologic Oncology Division in August, “and having people articulate what their fears are. I start every conversation with, ‘do you know why they sent you to see me?’

“I think it helps me to understand where the patient is coming from,” she continued. “Some people will say, ‘I have a really bad cancer,’ and others will say simply, ‘I have no idea why they sent me here’ — it’s that wide a spectrum. And then we go from there.”

These elements of education and communication, she continued, are just some of the things that make her work as an oncologist special, and each day different from the one before and after.

“I love my job; every day is different, and in a different way,” she explained. “I’m constantly learning, I’m constantly growing, and I’m constantly meeting really wonderful women. With some of them, I just cross their path very briefly because they have a cancer scare, and we do surgery, and it’s not cancer. And with some, I develop a life-long relationship where I’m going to take these women through their diagnosis and their treatment, maybe to a cure. And if not to a cure, then through their recurrences, and if they succumb to the disease, help them to transition to dying.

“It’s a wonderful job that I have.”

In this, the latest installment of its Today’s Physician series, The Healthcare News talks with Myers about the many aspects of her wonderful job — from direct patient care to work on clinical trials — and, in the process, explains why each day is indeed different.

Learning Process

When asked why she chose medicine for a career, Myers said, in essence, that this field chose her.

Her mother was an internal-medicine physician, and as a young child, Myers would often accompany her to the office. There, she was exposed to not only the clinical aspects of the work, but also the many aspects of the doctor-patient relationship.

“There was a great satisfaction that she enjoyed from taking care of patients,” she said of her mother. “Seeing how much she was loved by her patients was really inspiring.”

Myers graduated from Yale University with a bachelor’s degree in English, but knew her real passion was health care. She attended the Temple University School of Medicine in Philadelphia, and followed that up with a residency in obstetrics and gynecology at Temple University Hospital.

She began that tour of duty focused on high-risk obstetrics, but a mentor helped guide her toward oncology.

“She was a gyn oncologist who gave me an opportunity to do a lot in the OR and really rewarded my hard work,” she explained. “That’s when I decided I wanted to do gyn Oncology. A lot of medicine happens through mentorship; people choose their field because they had a great resident who let them deliver a baby; that’s what happened with me. I worked with great gyn oncologists and knew that when I grew up I wanted to be just like them.”

As her fellowship in gynecologic oncology at the University of Oklahoma was drawing to a close early this year, Myers commenced a job search. She said she had a number of job offers to consider, but ultimately chose Bay State — in part because she has family nearby (Westchester County in New York), but also because the position offered the attractive blend of experiences she was looking for, meaning everything from work with what she called “complex” cancers to those aforementioned clinical trials.

Four short months into her work in Springfield, she says she’s quite busy, is amassing a large base of patients, and is doing a lot of that educating and communicating that she described.

There are similarities with each patient, she said, but in many ways each case is different and unique, and this is part of what makes working as an oncologist so interesting and rewarding.

“Even though I deal with only five or six different kinds of cancer, each counseling session is a little bit different because each person has different needs, different levels of education, and different concerns,” she explained. “I’ll have one patient who has printed out 200 pages from a Web site and she’ll want to go through all this information, and another patient will say, ‘I just couldn’t believe they told me I had cancer; I couldn’t do anything.’ So you start with the basics.”

And the basics means more than simple medical care, she continued, adding that it means educating people, counseling them, and helping them address their fears, which often don’t even involve them and their immediate future.

“Most people are more scared for their families — they’ll say, ‘what does this mean for my daughters?’” she said, noting that many fear that a cancer history has consequences for succeeding generations. “They also say, ‘I need to live for other people; I am the main caretaker.’ For a lot of women, this is the first time they have to put themselves first and really make themselves a priority.”

And this is where the education part — that very large part — of the equation comes into play, Myers continued, adding that there are three main focus points for each office visit: to educate the women about what’s going on with their bodies, to figure out if there’s any way this could have been prevented, and to take care of the patient.

“I encourage them to start a health file so they can take ownership of their medical information — this is not just information that’s being passed around them and they don’t have a sense of what the pathology report shows or the CT scan shows,” she explained. “And I always try to include family; I think everyone represents part of a bigger puzzle. Some people only hear the ‘cancer’ word and nothing else you have to say, so I encourage patients to have other people be part of that conversation.

“Part of my job is to allow people to still have an identity separate from their cancer and separate from the diagnosis,” she concluded. “You’re going to have anxiety every time you have an appointment with me because you’re going to be scared that I’m going to find something, you’re going to concerned that the CT will show something, or the blood work is going to abnormal. But every time it’s not, we can step back and say, ‘wow, I was really scared, but we got through it, and now we’ll just enjoy the next three months.’”

The Last Word

Myers told the The Healthcare News that when she conducts surgery and the pathology report on a patient comes back and there is no cancer, she always asks that person to give her back her cancer pamphlets.

And there’s never any argument.

“People look forward to giving them back and gaining some sense of closure, a feeling that it’s over,” she explained, adding that for some it really is over, and for others, well, they’ll go through this again. The other part of the equation is that she needs those pamphlets for the next woman who has to hear her name in the same sentence as the ‘C word.’

The education process goes on, and that’s just part of what makes this job so challenging and rewarding.