Dr. Julie Palmer Researches Breast Cancer in Her Sister’s Memory

[00:00:00] Adam Walker: Komen has funded research for more than 40 years to find the cures for metastatic breast cancer, also known as stage four, but the five year relative survival rate for those living with MBC remains only 29%. That means seven out of every 10 people with MBC are expected to live less than five years.

This year alone in the us, nearly 44,000 lives will be lost to MBC. This week is MBC week, and we are publishing a new episode every day to shed light on the people who are impacted the most. When a life is lost to MBC, the husbands, daughters, sisters, and friends who are left behind each of our guests this week is driven by the purpose to help find the cures for. And to be a positive force for hope

From Susan G. Komen, this is Real Pink, a podcast exploring real stories, struggles, and triumphs related to breast cancer. We’re taking the conversation from the doctor’s office to your living room.

This is a promising time in metastatic breast cancer research. Many new treatments for MBC are under study and treatment is improving, allowing families more time with their loved ones. Today’s guest became a breast cancer researcher after her mother was diagnosed with breast cancer. Following her late sister’s MBC diagnosis and passing, she has dedicated her career to research that will help to identify women who are at especially high risk of metastatic breast cancer and to identifying lifestyle changes that may improve quality of life for women living with metastatic breast cancer. Here today to share their story in her sister’s memory and how her family history fuels her passion in searching for cures is Komen Scholar Dr. Julie Palmer. Dr. Palmer, welcome to the show!

[00:01:56] Dr. Julie Palmer: Thank you. I’m very happy to be here.

[00:01:59] Adam Walker: I’m so happy to have you and, and to hear your stories especially in honor of your sister. So understand you have a family history of breast cancer. Can you tell me about your mother’s experience first and then also about your sister’s initial diagnosis and subsequent recurrence?

[00:02:15] Dr. Julie Palmer: Sure, my mother was diagnosed with breast cancer while I was still a child. I don’t even know exactly what, you know, maybe in sixth or seventh grade, something like that, a long time ago. And in those days, the treatments were very different. But my, and most women, I believe, were given a, what was called a radical mastectomy.

My mother had that, and that completely cured that breast cancer. And then about maybe nine years later, she had a second primary breast cancer. That means she had breast cancer in her other breast and she, again, she had surgery and that cured. And my mother was lucky. She lived to be 93. And you know, the cancer never came back.

And her sister was not as lucky. She had was diagnosed with breast cancer about the same as age as my mother was the second time. So in their early fifties or so, and. . She died just a few years later. I think she kind of succumbed to some of the treatments, which the family was very private, so I don’t know a lot about that.

So I, but based on that, I knew I wanted to be a breast cancer researcher. My training is in epidemiology. As epidemiologists, we learn to study. Any condition we, you know, we have skills and knowledge for how to do that and to study a variety of exposure exposures or things that might cause the diseases.

 I have, as I said, focus most of my research on breast cancer and different aspects of it over the lifetime.

[00:04:02] Adam Walker: I love that. I love, So, so then that was your mother’s story. Share a little bit about your sister’s story as well.

[00:04:08] Dr. Julie Palmer: My sis sister was a wonderful person and we kind of went through life side by side because we were pretty close in age. She was a little bit older than me and like my mother, my sister was first diagnosed with breast cancer in her late forties before the menopause, but close to the age of menopause. And that’s an age at which breast cancer begins to be more common. Late forties, early fifties, that’s when you do see a lot of women being diagnosed with breast cancer.

Although it does become more common at 55, 60, but it’s not uncommon at that age. And when my sister was diagnosed, I think she wasn’t that scared. She was everyone who’s diagnosed with cancer of any type is completely life changing. It is it. It, it’s a terrible experience. At the same time, she maybe wasn’t as scared as other people because of our mother’s experience.

And at the time she had a, a daughter who was maybe in eighth grade or something, sixth or eighth grade, and she decided to have a mastectomy and have a double mastectomy, which, you know, the science shows. It’s not necessary to have that, but many women do choose to have a double mastectomy because they don’t want to be worrying all the time.

So, you know, there are many different opinions of that. But that is what she did. And she had a very good oncologist and she went for a second opinion at my urging and went to a very, very, Well known person at a cancer center and both agreed that given that she had stage one breast cancer and at what was known at the time, which now was 18 years ago, so they didn’t have all of the type DX and some of the things that are around now for, for figuring out prognosis, but still given the information they had, they felt she didn’t need chemotherapy or other.

Hormonal treatments. So she had her surgery and thought she would be fine, and she was fine. She was fine for eight or nine years, and then she discovered some little bumps on her chest and went to see her doctor. And her doctor sent her four scans, and that’s when she found out that the cancer had come back.

It had metastasized to her bones and to her lungs. And that’s when someone gets that diagnosis. Metastatic breast cancer, it means you cannot be cured, but your goal is to live a good life for as long as you can.

[00:06:58] Adam Walker: Hmm. Wow. And, and so how long did Beth live with MBC and, and was she able to continue normal activities or what was that like for her?

[00:07:08] Dr. Julie Palmer: I think she knew almost as well as I knew, and I certainly knew when she called me on the phone that this was a death sentence, but she, and she begged her doctor to tell her, you know, how long can I expect? Or what’s the average? And her oncologist. Very smartly said, I cannot give you an answer to that question because it, it keeps it, Not only is it different for every person, but it changes over time.

And at that time, I knew from my research that the median age for living with medicine. Breast cancer was about two years. So half the people died within two years, half lived longer. I didn’t tell her that either, and I knew that that would probably change and, and it has changed so much over time. Not to say that some people don’t die in the first year too.

They do, but women are living longer and longer. My sister. Nine years after that diagnosis of metastatic breast cancer. Wow. And she, those who were precious years, she saw her daughter through high school, through college and her daughter, my niece, and my goddaughter got her dream job out of college. As a kindergarten teacher in the New York City public School.

So she was able to move away from home just if not that many hours from where Beth lived, but sort of set herself up as an adult. And a year and a half later her mother died. But that was, you know, those years were so precious and I, and until the very end, the last few months, my sister. Lived a completely full life.

She kept her full-time job with the federal government. She was a administrative judge with the E E O C. So she heard employment you know, unfair employment practice cases, and she was very committed to that. She was an active mother involved in her daughter’s, you know, sports and all these types of things with all the other parents doing things.

And she had an advocation. She loved to play bridge and she was very good at it. She had won many World Championships with her partner, the Women’s World Championships, and she continued to travel to play Bridge. After this diagnosis of metic breast cancer, I think the, I think she went to China one time.

After that. She went to India for these tournaments were two or three weeks. Mm. And she won a couple more with her partner and she played in the US that they have three nationals a year. That’s what she loved. All her friends did that, and that’s what she used all her vacation time to do. And so her oncologist.

She was treated at one of the comprehensive cancer centers, and her col oncologist made it possible for her to do this by scheduling her chemo. She had infusions of regular chemotherapy and infusions to make the bones stronger. And for a while she was on septin and, you know, so she had like, she was in there a lot and the oncologist was able to organize them around so that she could travel.

Wow. And it wasn’t, it wasn’t easy because the first couple years to maybe three years, she didn’t have to have chemotherapy. She took the aromatase inhibitors because she hadn’t had them before. So they were effective. And with all the advances and research on treatments, She really benefit because she, like many other women would start on something, it would work for nine months or maybe the first one, maybe a little longer.

And the scans happen every, I think three months, three to six months, depending. And then when they, the cancer for coming back in different sites, they would change her to another and that would work for a while. And when those stopped working, then there was a chemotherapy. And so she, Wearing a wig for the last six years of her life, and she, that’s what she did.

She went down to that cancer center, you know, drove herself down, sat there, brought her lunch, you know, was around all those fabulous nurses that do that. Treat oncology patients. And she really did. I don’t, we don’t know how, and she had a couple bad spells. One point early on they didn’t realize the cancer had come back in her spine enough that she was in.

Absolutely intolerable pain. And she had to have surgery afterwards to remove parts of the, the tumor from there. And we didn’t know if she would make it. And she didn’t, never wanted to live with that pain again. But after year, she was better and she went on to have many good quality years.

[00:12:16] Adam Walker: She sounds remarkable. Like a, like a force to be reckoned with. I love that. It’s so inspiring. So inspiring. Well, so, so talk to me about MBC treatments and, and research. How is your work specifically contributing to improving quality of life?

[00:12:33] Dr. Julie Palmer: So since I’m an epidemiologist and not a, a practicing physician or a basic scientist, where by basic scientists really work on the mechanisms that lead to the drugs that help to.

 Prevent the further growth of tumors, which is what we want from metastatic breast cancer. What I do is study populations to try to figure out what’s helping one group that isn’t helping another, you know, what, how these things work, and, and especially studying factors other than medications that may also lead to.

Better quality of life for women who already have metastatic breast cancer or a lower chance of the cancer escaping the initial site and becoming metastatic so that my research. Towards the latter is actually doing, studying large groups of women who’ve developed stage one, two, or three breast cancer and finding out how as free living people are there differences if they have regular physical activity versus not if they diet, eat a diet higher in fruits and vegetables, for example, or some other type of diet.

 Whether some of the medications that are given for other conditions, common conditions like hypertension and diabetes may actually help improve their outcomes. So that’s part of my research. And the other part having to do with women who already have metastatic breast cancer is research on factors that contribute to a better quality of life over those years.

[00:14:18] Adam Walker: It’s fascinating. I love that. I love that. And, and thankful for the research that you’re doing. So I, I’m curious, as a breast cancer research, what was it like to watch your sister go through this experience?

[00:14:36] Dr. Julie Palmer: Well, I will tell you it definitely made me more interested in studying. Survivorship versus causes of breast cancer, which earlier I had been more focused on.

 It, it gave me, it brought to me as a researcher, a very different point of view. It added to my starting point. You know, you can only read so much and get so much from it, but when you’re in that experience with someone you love, Then every study you’re doing or questionnaire you’re developing, there’s just something different in there that you want to ask or want you to know about.

For example, one of the things I learned every time I visited my sister, I would see a dining room table covered with papers, bills, and insurance forms, and all. And my sister was someone who had a decent insurance plan from the federal government. Nevertheless, insurance never covers everything, and with that whole spinal surgery she had and different things, you know, they were always, and you get bills from so many different people, not just a hospital, but anesthesiologist, a surgeon.

We’ve all heard about that. It’s a huge burden to keep up with. And it’s a burden to pay all those extra costs. It, but it’s, it can be a full time job even just to do that. And then when you take someone who has a different job that doesn’t have this good insurance, you know, I just wonder how people can do it.

[00:16:17] Adam Walker: Yeah. I would imagine that that experience, I mean, it. It really in a very intimate way for you, puts a face with all of the work that you’re doing, right?

[00:16:25] Dr. Julie Palmer: Right. It does. And then another aspect was as soon as my sister’s breast cancer came back, I became, in a way, her patient navigator. So I could, you know, be a step ahead.

I could help her interpret. These recommendations she was getting what the treatments would be like. You know, the side effects when she went for her first chemo and she called me and said, I feel so nausea. You know, I could say, Well, this is when you need to call the nurse. This is what they’re there for.

They want to hear from you because they can change. Your next infusion can be different and people don’t know. And you know, that’s why the patient navigation programs, which actually Komen was, you know, instrumental in first developing and supporting these programs, and we still need for them to be much more widespread than they are, you know right now.

So it, yeah, it’s made me aware of how important patient navigation is.

[00:17:28] Adam Walker: I can only imagine how valuable you must have been as a patient navigator just being able to help her walk through that. So that must have been really been a blessing. So it back to you a as as a sister. Is there anything specific that’s helped you heal ex since experiencing your sister’s passing?

[00:17:48] Dr. Julie Palmer: I think the biggest thing is, And we’re coming up to three years pretty soon. My brother mentioned to me last night, because, you know, everything’s connected. Different, different trips or different other events. So but the biggest thing has been my relationship with my goddaughter my sister’s only child, and.

Who happens to be close in age to my daughter, but I have this independent relationship with my goddaughter. I consider her my other daughter. And when I talk with her on the phone, it’s not the same, but it brings a lot of that joy that, and I, I miss it. It helps me not miss that relationship I have.

Sister so much. It’s hard to explain, but my sister and I talked about everything on the phone. We talked about once a week and we knew everything in each other’s lives. And I happen to know, she shared a lot with, with her daughter because they were very close and she shared everything about her daughter with me.

So when I talked with, when I talked with my niece, I know she knows a lot of back stories and it’s really fun. She’s only 27, but we have a lot of fun together. That’s fantastic. Helped me heal and, and then so amazingly I was going through some photos for, actually for the October Breast Cancer Awareness month.

 And I saw a picture of my sister wearing one of the Komen walk t-shirts, and then I remembered that she did that in the early years. I, I, I can’t actually, can’t remember, was before the Mensac or after, but she did it a few years and her daughter was a kid then did it with her. So I was bringing up to my niece and she said, I want to do that again.

And I said, I want to do it with you. . So those, you know, those are the kinds of things. That’s why when you go to the walk, if you ever go to one, you see that people were there and they dress up in all sorts of things. And it’s, you know, when you’re with other people and people have shared that experience, it is a healing thing.

[00:19:54] Adam Walker: Mm-hmm. . Yeah. Yeah. It is, it is a healing thing. So inspirational too. And I’m, I’m so, I’m inspired by your relationship with your goddaughter too. That’s amazing. Is there anything else, any other special ways that you and your family honor Beth’s memory?

[00:20:08] Dr. Julie Palmer: No, we just we just, every year on her birthday, which was last month, and then on the time of her death, we just remember her and, you know, come together even in person or by Zoom and you know, share a moment.

And luckily we were all, my family was all in Boston in August for my daughter’s wedding, and the day after was my sister’s birthday, and my brother had brought all these photos. He dug out photos from. My sister’s childhood all the way through to later in life. And, and there we were at breakfast and my niece was there, you know, others were there.

And he said, I just wanted to share these at breakfast today. And, you know, that was really special.

[00:20:56] Adam Walker: I love that. I love that. Well, last question and, and, and also just thank you for, for sharing the, these intimate stories with us. It’s so beneficial, so inspiring. Last question. Do you have any final advice for any of our listen.

[00:21:12] Dr. Julie Palmer: I think anyone who has breast cancer or and including metastatic breast cancer, I would just say, you know, it’s a, it is a really hard thing and people, the people who love you are really there to help. And I would say let them help. You deserve it. You know, we’re all people. We’re all people who care about other people, and other people want to care about us.

[00:21:39] Adam Walker: That’s right. That’s great advice. Well, Dr. Palmer, thank you so much for joining us on the show today.

[00:21:45] Dr. Julie Palmer: Thank you. I, you know, I’d love talking about my sister, if so.

[00:21:51] Adam Walker: Me too. Me too. All good.

All funds donated to Komen this week will be dedicated to funding the cutting-edge research to one day end MBC. People living with MBC are desperately waiting for new treatments to extend and improve their quality of life. Visit Komen.org/supportMBC to donate.

Thanks for listening to Real Pink, a weekly podcast by Susan G Komen. For more episodes, visit RealPink.com. For more on breast cancer, visit Komen.org. Make sure to check out at Susan G Komen on social media. I’m your host, Adam, you can find me on Twitter @AJWalker or on my blog, AdamJWalker.com.