Breast and ovarian cancer diagnoses help clinical dietitian empathize with patients
Kellie Bramlet Blackburn
Senior clinical dietitian Christie Siebel can empathize with her patients. With their pain following surgery. With their nausea after chemotherapy. With their worries and their doubts. She knows because she’s been there.
“MD Anderson is why I became a dietitian. It’s the reason why I’m still here, and it’s why I’m such a good dietitian,” Siebel says.
BRCA makes breast cancer diagnosis a matter of when, not if
Siebel first came to MD Anderson in her teens while caring for her mother through breast cancer treatment. It was then that she met a clinical dietitian and became interested in the career. After another family member was diagnosed with breast cancer, Siebel underwent genetic testing and learned she carried the BRCA genetic mutation, which made her more likely to develop breast cancer and ovarian cancer.
“For me, it was a matter of when would I develop breast cancer, not if,” she says.
‘When’ came shortly after the birth of her daughter six years ago. Siebel was 30 years old. She had been breastfeeding the baby when she noticed a lump and told her doctor right away. It could be a clogged milk duct, the doctor told her. Or it could be something else.
The day Siebel returned to work, just 12 weeks after her daughter had been born, she received a call from her doctor. The biopsy showed she had triple-negative breast cancer. Her doctor recommended she seek treatment at MD Anderson. Given Siebel’s age, family history and that triple-negative breast cancer can be aggressive and hard to treat, she needed their expertise, her doctor explained. As an MD Anderson employee, she didn’t need much convincing.
Relating to patients during triple-negative breast cancer treatment
Siebel met her entire care team right away, including her oncologist, Rashmi Krishna Murthy, M.D., her breast surgeon, her plastic surgeon, Mark Villa, M.D. They answered her questions, listened to her concerns and detailed her breast cancer treatment plan: eight rounds of chemotherapy followed by a bilateral mastectomy. She also decided to undergo an additional surgery for breast reconstruction.
Through it all, Siebel kept working to serve her patients.
“As a patient, I felt heard. I felt supported,” she says. “It taught me a lot about being a good provider.”
Siebel received chemotherapy every three weeks on a Friday. She would take that day off so the fatigue and nausea would hit her over the weekend. By each Monday or Tuesday, she felt well enough to return to work.
The experience helped Siebel relate to her patients. While she always clarified that everybody is different, she offered tangible proof that chemotherapy wasn’t necessarily as bad as they might have imagined and wouldn’t necessarily keep them from work and family. She was also proof that a really good wig did in fact exist.
Feeling lucky after ovarian cancer surgery
With chemotherapy complete, Siebel was able to put her own cancer treatment behind her. But as a BRCA carrier, Siebel knew that she was also at risk for ovarian cancer and had begun considering when she should undergo a preventive procedure called a prophylactic salpingectomy. The day that she planned on telling her care team she was ready to schedule the procedure, her care team told her they had found a complex ovarian cyst. Siebel would need surgery to remove it, gynecologic oncologist and surgeon Pamela Soliman, M.D., told her.
In early March 2020, Siebel had her surgery. Soliman had warned her that they weren’t sure what the cyst meant. It could just be a cyst, or it could be ovarian cancer. They planned for a minimally invasive surgery to remove the cyst, but the biopsy taken during the surgery showed that Siebel did in fact have ovarian cancer. So, Soliman pivoted to perform an open surgery to remove the tumor. Siebel was surprised, but was glad Soliman had done what needed to be to remove the cancer.
Due to COVID-19 precautions, Siebel was unable to have any visitors while she recovered in the hospital for the next week. But her coworkers checked on her and kept her company.
Connecting with patients puts things in perspective
Following surgery, Siebel again underwent an additional six rounds chemotherapy. Just as before, she kept working to care for MD Anderson patients. This time, she didn’t wear a wig. She wasn’t trying to hide anything, and the Texas summer heat made it too hot. It also served as a conversation starter with patients on their shared experience. Their conversations helped Siebel just as much as she helped them.
“My patients put what I was going through in perspective,” she says.
Feeling lucky after cancer treatment
Now Siebel attends an annual follow-up appointment for breast cancer and undergoes a CA125 blood test every three months to follow up on the ovarian cancer. She’s doing well, and both her prognosis and her outlook are positive. She’s empowered by the fact that both her cancers were caught early and treatable.
“I felt lucky the whole time,” she says. “I still do.”