Tahoe doctor fights metastatic breast cancer
October 28, 2015
Scan, treat, repeat.
Those three words are how Dr. Kelly Shanahan, like most people with metastatic breast cancer, lives her life.
The 55-year-old OBGYN from South Lake Tahoe was first diagnosed with breast cancer in 2008 during a routine mammogram, but after a bilateral mastectomy, months of chemotherapy and reconstruction, she thought she would be cancer free.
"I thought I was good, thought I was done with cancer and I kind of went on my merry way," Shanahan said. "I am an OBGYN and I was put on a medication to try to reduce the chances of a reoccurrence but they had a lot of side effects that made it difficult for me to do surgery, so I did not complete the full five years of that. But I thought I had the mastectomy and I had chemo, so they killed all the suckers."
“Dr. Perez sat down and looked me in the eyes and he said I know you know the statistics and you are not a statistic. And I told him he was hired on the spot and we chose to do a very, very aggressive treatment.”Dr. Kelly Shanahan
But in the summer of 2013, Shanahan sneezed while walking up the stairs in her home and started experiencing terrible back pain.
"I thought I pulled a muscle, but it didn't get better," Shanahan said. "I got a couple massages, went to the doctor, and it didn't get better, so I thought well you know I am in my 50s I probably herniated a disk."
It wasn't until six weeks later she was able get an appointment with colleague Dr. Jorge Perez with the Carson City Sierra Cancer Center for an MRI and a Positron emission tomography scan to check and make sure everything was OK. Shanahan said she was getting into her car after the tests when Perez left her a voicemail asking to call him on his cell phone.
"Immediately, I knew that my cancer was back," Shanahan said. "And it was literally in every bone in my body: skull, back, the reason my back hurt and why I was limping was because I had actually broken my vertebrae. I had a spot on my left femur that if I had tripped I would have broken my leg. I was in Dr. Perez's office within two hours of having my scan, my husband drove down from Tahoe, and as a doctor the first thing I did was look up the statistics and the stats for metastatic breast cancer are not good."
Metastatic breast cancer is a form of breast cancer that spreads to different parts of the body. Nearly 40,000 Americans with metastatic breast cancer die per year. The typical person lives only 33 months after diagnosis and only 22 percent live five years after diagnosis.
"Dr. Perez sat down and looked me in the eyes and he said I know you know the statistics and you are not a statistic," Shanahan said. "And I told him he was hired on the spot and we chose to do a very, very aggressive treatment."
The treatment the two decided on was a different treatment than most oncologists use. Perez recommended Shanahan use two different drugs and try to hit the cancer from multiple sides to keep it "confused" for longer.
"Cancer cells are sneaky and devious and smart," Shanahan said. "When you use a treatment for a while the cancer cells usually mutate so that the treatment is no longer effective. Well, four months into the treatment, we did a PET scan and where I lit up like a Christmas tree in November in April there was no active disease."
For patients with metastatic breast cancer, there's no cure presently for the disease. The best way to treat it is to maintain stable periods of no activity for the cells. This is referred to as NED or no evidence detected.
"It is there, the cells aren't actively diving, so there is no evidence of disease," Shanahan said. "It's there we just can't see it. At some point it will figure out what we are doing with the drugs I am on and it will start spreading and it will go around my body and maybe to an organ like my lungs or my liver or my brain and then we will do another treatment. The goal for me is to stay stable until there are some cool new treatments."
Because there's no cure for this type of cancer, stability is key.
"People will ask 'are you done with treatment,' and the answer is no, I will never be done with treatments until there are no more treatments left and then I will die," Shanahan said. "Which I don't plan on doing that for a while.
"All of us in the metastatic breast cancer community kind of live from scan to scan. One of our slogans is scan, treat, repeat. Because our treatment never ever ends, we tend to call ourselves thriver, forever fighters or METavivor, which refers to the disease and living through it, so I tell people that I am living with metastatic breast cancer."
However, she said she isn't going to let this cancer get her down.
"People look at me and think how can you use the word die and use it so casually," Shanahan said. "It's because it is because I am living every second until that happens. I wish it didn't take a terminal illness to get me to this outlook on life, but you really do learn not to sweat the small stuff."
So though Shanahan can't practice as a full-fledged OBGYN anymore, she's content with living out her new path in life: as an advocate for metastatic breast cancer.
On Oct. 13, Shanahan and 112 other metastatic breast cancer patients — the number of people who die daily from metastatic breast cancer — went to the U.S. Capitol for Metastatic Breast Cancer Awareness Day. At the Capitol, they had a "die-in" to raise awareness and encourage more funding to find and create more effective treatments.
"It is kind of crazy in 2015 that 40,000 people a year that die from metastatic breast cancer, and that number hasn't changed in 40 years and that is why we need more research into why do some cancers metastasize and others don't," Shanahan said. "Can we figure out a way to figure that out? Can we do something to keep it from happening?
"For people like me, the horse is already out of the barn I don't need to stop it but can we stop it in the tracks? We need treatments so that our cancer can be controlled. I would like if there were research to find treatments to turn this into a chronic disease that would allow me to live with the cancer for 10-, 20-, 30-years. We don't have that right now and the treatments we have are toxic, going through chemo is not for the faint of heart."
A NEW PASSION
For now, Shanahan hopes to work as a spokeswoman and is hoping to apply for a cancer support panel with the Department of Defense to work on getting politicians to better allocate cancer research funds.
"I want to do more in the metastatic breast cancer community which means meeting with drug companies and meeting with people in Congress and writing articles doing these things so that I can spread the word and make a difference," Shanahan said. "That is one thing that I am passionate about is educating people about metastatic breast cancer."
But more importantly, Shanahan is making sure she sticks around so she can be with her husband and their 16-year-old daughter and enjoy all the little things in life like going to the movies with her daughter and concerts with her husband.
"I am more than my cancer," Shanahan said. "I am still a mom and a Dr. Who fan and I love to read and do all these things."
As of her last PET scan in August, Shanahan is stable, treatments are working, she has finished with her chemotherapy for now and on an oral medication. When the cancer becomes active again, she said she's going to get it biopsied to do genetic testing to see if researchers can learn more about cancer and genetics.
"I know that at some point I will progress and when that happens we will figure out where to go from there," Shanahan said. "But when I do progress we will have it biopsied so that we can do genetic studies on it and see if we can do a targeted treatment for my cancer."