Breast surgeon forges additional advocacy role after becoming a patient herself
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After immigrating to the U.S. from India as a teenager, Deepa R. Halaharvi, DO, knew that she wanted to become a physician.
It was only 8 months after becoming a breast surgeon in 2015 that she was diagnosed with stage I, hormone-receptor-positive, HER2-negative breast cancer, giving her the unique insight into what it was truly like to be in her patients’ shoes.
Halaharvi, breast surgeon in Ohio, spoke to Healio about how her experience as a patient with breast cancer has changed the way she practices and the importance of never giving up hope.
“I have gained a significant amount of empathy and compassion in being able to put myself in patients’ shoes,” Halaharvi said during an interview. “I always tell my medical trainees, fellows and residents to put yourself in the patient’s shoes and know the feelings that a patient goes through when they are told that they have cancer. I became one in eight women diagnosed with breast cancer. I had to go through all the emotions that patients go through — denial, anger, bargaining, depression, and finally, acceptance. I’ve been through all of those feelings and know that meeting the patient where they are in life is key.”
Patient advocate
It was Halaharvi’s personal experience with a breast cancer diagnosis that changed the way she practices as a surgeon.
“I see patients before they are diagnosed with cancer — whether they come in with an abnormal mammogram or a mass that they felt in their breast — and I usually know at that time whether it is cancer or not,” Halaharvi said. “I prepare them and tell them that I am worried about the mass. I show them the images and tell them a generalized plan, then I call them as soon as I get the results, which is something that changed after I was diagnosed.”
Before her diagnosis, Halaharvi said that she would often wait until the next morning to give patients their results that she received the night before.
“Now I call them that night, over the weekend or whenever it is that I receive the results and then bring them back in to my office as soon as possible. I then show them the images again and go through the pathophysiology of the cancer and tell them their treatment options. It is always a shared decision-making process. As the patient goes through their cancer journey, my job is to not only cut out the cancer as a breast surgeon, but to also help the patient.”
In speaking about the importance of personalized medicine and genomic testing, Halaharvi said women need to be their own advocates and seek out the different options that are available to them.
“The Oncotype DX Breast Recurrence Score Test [Exact Sciences] is one example that is so important as it is the only genomic test that is predictive and prognostic for individuals with early-stage, hormone receptor-positive, HER2-negative breast cancer,” Halaharvi said. “The test provides the likelihood for cancer recurrence, as well as whether chemotherapy will benefit them or not. I was diagnosed in 2015, but if diagnosed 10 years earlier, I would have received chemotherapy that I did not need. Thanks to this test, I was able to avoid chemotherapy, which is not without side effects, including neuropathy, hair loss and several other effects that are life-changing for women. As a physician, I worry about being able to use my brain, fingers and hands because those are what are most important for me to be able to operate on patients.
“Having that information that I did not need chemotherapy was wonderful for me,” she added. “I felt empowered. Women need to be their own advocate.”
Hero of Hope
Based on her work as a patient advocate, Halaharvi received the American Cancer Society’s “Hero of Hope” award. The award recognizes an individual’s efforts as a patient with cancer who has provided outstanding contributions to the cancer community.
“I felt very humbled to receive the award,” Halaharvi said. “Hope is an important word for me. In fact, I have a website, drdeepahalaharvi.com, and a podcast, The Breast Cancer Podcast, that emphasize the importance of maintaining hope through diagnosis and treatment.”
As a cancer physician, Halaharvi said it is important for her to never take away a patient’s hope, regardless of the cancer diagnosis or prognosis.
“I truly believe a clinician’s mission is not only to prevent death, but to improve the quality of life for their patients,” she said. “When treating a disease, we may win or lose, but when we treat the person, we will win every time no matter the outcome.”
Halaharvi also led a virtual cancer wellness prevention lecture series for laypeople during the COVID-19 pandemic, and is actively involved in her community, specifically churches, mosques and temples, where she emphasizes to women the importance of self-breast examinations and mammograms.
“It is important for women to see other women who look like them and who may be or have gone through a cancer diagnosis,” she said. “For those not diagnosed with cancer, [it is important] to listen to what someone who looks like them has to say regarding breast cancer screening. Just because I am a doctor, I am not devoid of all the troubles and obstacles in life. They see me, and I look fine. I make it a point to take care of myself, to exercise and eat healthy. I make it a point to dress up and feel good, because people look at that and they want to be like that, too. They want to feel good, to be happy and have joy.”
Women are bad at taking care of themselves because they are trained to take care of everybody else, Halaharvi added.
“We need to change that dialogue,” she said. “To take care of your family, you have to take care of yourself.”
Serving others
Halaharvi said that in addition to advocating for the importance of hope, two of the most important things in life to her are to empower women and to serve her community.
“I want to empower women to be their own advocate and to ask their physicians for what they need. I tell my patients that my goal is not just for them to become a survivor but a warrior and to thrive through the situation. It is interesting that with this approach, patients go from being scared when they are diagnosed to enjoying and living their life to the fullest because a cancer diagnosis becomes a wake-up call for many of them,” she said.
Providing service to others is a privilege and a gift, Halaharvi added.
“We are only here on this earth for a short time,” she said. “Death is a definite, so what we do from the time we are born to the time we die is so important.”
For more information:
Deepa R. Halaharvi, DO, can be reached on Twitter @DeepaDhalaharvi.
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