Frontline Fighters
Breast cancer survivors get much of their strength from those who support them. We meet seven specialists who have made it their life’s mission to cure this disease.
Erica Whineray Kelly
Breast Cancer Surgeon, Auckland Breast Centre and BreastScreen Waitemata Auckland; Trustee and Executive Member of the Auckland Breast Cancer Study Group
I chose this career because ... It has been a life-long dream to be a surgeon. I love the people, it’s fascinating work and there is always more to discover.
My typical workday involves ... My husband and I get the children ready for school and I drop them off. After that it is four hours of either operating or consulting with patients at my rooms. I have about an hour to tidy up any work and have lunch before picking up the children from school and doing the ‘mum’ thing until they go to bed. If I have more paperwork or reading to do then it is after the children go to bed.
What I like best/least about my work ... Best and least would have to be the same thing – breaking bad news. It is very hard to tell someone they have cancer, but at the same time I consider it a privilege to do it well; with compassion, imparting hope and trust and a belief that I will do everything I can.
My career goals are ... I'd love to discover something!
When I'm not working, I like to... Friday nights would definitely be with Mark, steak for dinner, red wine, and if I don't fall asleep, a DVD at home, laughing with Olivia and James, and running (gossiping) with some great girlfriends.
One of the rarest things I’ve seen during my career was … A 5kg breast lump that wasn’t cancer in an Irish woman’s breast when I worked in Dublin.
The hardest question I’ve ever had to answer was … Is my daughter going to die?
The one aspect of my work that gives me the most satisfaction is … The wonderful women (and families) I treat. I learn a little bit from each of them and am constantly inspired by their strength and dignity.
The best piece of advice I have been given in my career was … You cannot save everyone but you can make it better.
What traits should a good doctor have? They should be pedantic, honest, have the personal strength to recognise their own vulnerability, realise they have a vocation not a job, try and try harder and never forget what a privilege it is to walk alongside patients as they confront life and death.
Belinda Scott
Breast Surgeon and Managing Director of Breast Associates, Auckland
How did you become a breast surgeon? I have been a breast and general surgeon for 20 years. I trained in Otago, spent some time training overseas and opened my own practice 15 years ago. I felt it very important that women were offered a combination of excellent care in a professional and caring manner.
When I first started there was only me and a nurse! Over the years our numbers grew and now there are three surgeons, three nurses and three breast physicians. Not to mention the wonderful support staff needed to run the business
Tell us about a day in the life of a breast surgeon … My normal day starts at 7.30 a.m. and I’m in surgery by 8.00 a.m. as we want to get as much as possible out of the day.
I will often operate until 12.30 p.m. then go to a clinic in the afternoon. This runs from 1.30 p.m. to 6.30 p.m. or when it finishes!
I love my job which is really important as it is hard with long hours and emotionally and physically exhausting. The fitter I am the easier it is to do these long hours. Sometimes I can operate for up to eight hours so concentration is imperative. My work is varied, not just operating but also diagnosing problems, dealing with complications and also being able to listen to the needs of my patients.
I am also the current chair of the medical committee of the NZBCF. This takes a lot of extra time with meetings either 7.30 in the morning or late at night.
The foundation does an enormous amount of good,with education, research, sponsorships, and raising awareness of breast cancer.
What traits should a good doctor have? I feel it is important to not only be compassionate but also to keep up with advances in medicine. This enables a good surgeon to offer good advice with a background of research and studies to back up the advice.
We should always be looking at ways to improve what we do, by gaining new knowledge and by listening to others – including our patients.
Birgit Dijkstra
Breast, Endocrine and General Surgeon
Christchurch Hospital and Canterbury Breast Care
I chose this career because... I love helping people, and being able to make a difference.
My typical workday involves… An early start, up before 6.00 a.m. and away by 7.00 a.m. Ward rounds, sometimes at two-three hospitals, followed by either an operating session or clinic, and the same in the afternoon, either operating or clinic followed by further rounds before heading home, usually around 6.00-7.00 p.m. One day per month all day on-call at Christchurch Hospital.
What I like best/least about my work is… Being able to make a difference and give treatment and hope to my patients. What I like least is having to give bad news. However, at least I can usually have a plan in place for treatment, but it’s always hard.
My career goals are… To continue to give up-to-date treatment to my patients, to encourage ongoing research into the treatment and prevention of breast cancer, to teach young surgeons coming through and ensure great communication with their patients.
When I’m not working, I like to… spend time with friends and family, walk with my dog, spend time in the garden, cook some nice food, or relax in the Marlborough Sounds.
One of the rarest things I’ve seen during my career was… A woman who presented with severe abdominal pain then proceeded to deliver a baby without realising she was pregnant!
The hardest question I’ve had to answer was… ‘What would you do in my situation?’ This is an impossible question to answer.
The one aspect of my work that gives me the most satisfaction is… To see patients come through their surgical treatment and continue on with their life. It’s great to be able to potentially cure people.
The best piece of advice I have been given in my career was… To always be honest, never take short cuts and to make sure you enjoy your work!
What traits should a good doctor have? Honesty, integrity, passion, empathy, good communication and enjoyment in their work.
Richard Isaacs
Medical Oncologist and Chair of New Zealand Breast Cancer
Special Interest Group since 2008.
Palmerston North Hospital, Aorangi Hospital, Palmerston North
I chose this career because ... I really enjoyed my time in the Auckland medical oncology unit when I was a medical student. I found the compassion of the staff and the honesty of their communication contrasted starkly to other areas I had experienced. I also believe the interface of science and clinical practice is unique amongst medical specialties, with scientific discoveries leading to real improvements in care.
What I like best/least about my work ... I really enjoy communicating with patients, looking for the positive aspects and a little humor in every situation. Clearly to be able to treat cancers effectively and to sometimes cure patients is one my primary goals and a benchmark for measuring success, but effective symptom control both in the hospital and hospice is also very rewarding. To advocate for the best treatments and then be able to deliver them to New Zealand patients, knowing we can then offer them the best outcomes also makes my job very worthwhile.
I don’t enjoy working in a situation of great stress, due to inadequate staff numbers, when we are being pressured to treat an increasing number of patients as quickly as possible – it isn’t humanly possible and we have had to prioritise referrals to cope. Hopefully our staffing will improve, but there has been little structured health policy to recruit adequate numbers of cancer specialists.
My career goals are ... To continue to provide the best quality care possible for New Zealand cancer patients. To achieve work/life balance and not to burn out!
One of the rarest things I’ve seen during my career was … Seeing a woman as a new patient with advanced bowel cancer whose husband joined the consult late as he had just been to see his doctor and been told he also had advanced bowel cancer. I treated both husband and wife with the same chemotherapy for the same disease, but it behaved very differently in each of them. A unique situation I never wish, nor expect, to witness again.
The hardest question I’ve ever had to answer was … ‘How long do I have to live?’ It is also the bravest question. We simply don’t know the answer for an individual and the common approach of giving a specific time is, I believe, frankly harmful. Careful explanation of the disease state and options for change is much more constructive.
Louise (Lou) Hayes
Breast Surgeon
Waikato Hospital
I chose this career because ...The things I enjoyed most during my medical training were the practical skills of surgery and the communication and interaction with patients themselves. For me the field of breast surgery provides the perfect combination of both of these aspects and as a result is a constantly challenging and satisfying career.
My typical workday involves … Most days at Waikato Hospital start with a morning meeting with colleagues, both surgical and from other areas of the hospital, to discuss patient management and get updates on the latest developments in relevant medical and surgical practice. I have a breast clinic most weekdays where I will see women (and the occasional man) with a wide mix of breast problems ranging from benign conditions to breast cancer. One or two days a week I also have an operating list that is mainly filled with breast cancer cases.
What I like best/least about my work … The best thing about this job is without a doubt the amazing women I meet. The strength and spirit I see every day in the women I deal with is a constant source of inspiration.
The worst aspect of this job is of course breaking bad news. This does not get any easier with practice but at least with so many advances in the treatment of breast cancer there is also the ability to offer hope and optimism.
When I’m not working I like to … I have a ridiculously cute and adorable dog who has me wrapped around his little paw and demands regular walks and attention. I am still in the process of exploring New Zealand and when I get the time I have been known to play the viola in a local orchestra.
One of the rarest things I’ve seen during my career was … In the early days that would have to be another female surgeon…. We were few and far between back then!! Luckily that is changing.
The one aspect of my work that gives me the most satisfaction is ... The ability to help women through what can be a very difficult time in their lives and hopefully to make that journey a little easier. I think that is the aim and focus for all of us involved with health care and being part of the team that achieves that provides unbeatable job satisfaction.
The best piece of advice I have been given in my career was… ‘Listen, to what is being said and what is not being said’.
Marion Kuper-Hommel
Specialist Medical Oncologist
Waikato DHB, Hamilton and visiting medical oncologist at Lakes DHB, Rotorua
I chose this career because ... I love to work with people. People with cancer are forced to think about what really matters in life and have to set their priorities. They value life much better and a cancer diagnosis often brings the best out in someone. I feel very privileged to be involved with the cancer journey of so many people. I learn a great deal from my patients who often deal with life in a very admirable way.
My typical workday involves ... Dealing with patients and the ones closest to them in a face-to-face consultation, discussing the management of their cancer and all factors related to that. Discussing their management in multidisciplinary meetings. Waikato DHB has site specific MDM’s for each cancer type.
What I like best/least about my work ... Best: to learn from people who have been able to achieve a great inner growth during their cancer journey.
Least: People who struggle and battle till the end and fail to accept life as it has presented to them. It affects me personally when young children are involved.
My career goals are ... Being involved in all aspects of breast cancer care, ranging from optimal patient care, to the development of clinical trials and getting access to the best and newest drugs for my patients. Collaborating with breast cancer experts at a national and international level and trying to be innovative. Finishing my PhD, which is currently in its final phase.
One of the rarest things I’ve seen during my career was … The high incidence of inflammatory breast cancers in the Waikato region. Inflammatory breast cancer is a rare disease, comprising 1-2 percent of all breast cancers. For some unexplained reason they occur much more commonly in the Waikato region.
The best piece of advice I have been given in my career was … Live your life as if every day could be your last one. Enjoy every new day and finish it feeling that it was the best day of your life.
David Porter
Medical Oncologist
Auckland Hospital
I chose this career because ... It was by chance really. I failed the physician’s exam and could not do my advanced training as planned, so had to do something else until I did pass. That something else turned out to be a medical oncology run at Wellington Hospital, working for Dr Peter Dady. It was a great experience, I found Peter hugely inspirational, as he was very focused on making people rather than their cancer better and it was really gratifying to see people recover because of the intelligent use of medical treatments, and it all started from there.
What I like best/least about my work ... Seeing people with desperate symptoms get better because of something I have done. A particularly good example is someone I am seeing at the moment who was paralyzed, but who can now walk almost independently. It’s important that people obtain good quality time that they can use meaningfully wherever possible, even if we are destined to lose the fight against their cancer sooner or later.
I particularly dislike seeing the mothers of young children dying, as there is no one else who can fill these women’s shoes for their children. On one occasion I recall keeping someone alive with treatment for over five years in this situation, after they had been told to go home to die with a prognosis of a few weeks only. If I only achieved that once in my career it would make it all worthwhile, but it’s thankfully not an isolated case.
One of the rarest things I’ve seen during my career was … The strangest good thing that I have seen is someone who had a huge mass that disappeared for no reason. And they weren’t having any alternative or complementary therapy.
The hardest question I’ve ever had to answer was … ‘Why did my mother/father/child die as a result of treatment?’ It’s a pretty ugly situation to be in, but inevitable from time to time with the treatments we prescribe. The difference between a medicine and a poison is the dose and with chemotherapy it can be a fine line.
The one aspect of my work that gives me the most satisfaction is … Seeing people whose lives have been transformed by what my team and I have done for them. Some of my favourite memories are of someone we treated with what, at the time, was an experimental treatment and who is alive 10 years later as a result. Seeing people whose cancer was cured by the treatment I prescribed out and about with their children, and seeing people who were once paralyzed with pain living normal lives.
The best piece of advice I have been given in my career was … Avoid “gestural” treatment. It’s one of the many sound pieces of advice Peter Dady told me at the start of my fledgling career, and I think it’s crucial to do so. What this actually means is that we should consider whether we are more likely to inflict greater harm on someone by treating them because of side effects that effect some improvement. It’s an important consideration when facing patients in a really desperate situation who want highly toxic therapy that is unlikely to make their cancer better. Medicine should be about the whole person, not just the cancer.
