CLINICAL
CARE T RE VR ME RC H ANT
MD Instant Gratification BREAST SURGEON, SARAH TEVIS, MD, HELPS PATIENTS BALANCE CANCER CARE WITH REAL LIFE B Y E R I K A M AT I C H
Instant gratification is the desire to experience fulfillment without delay. It’s not always a good thing. Unless you’re Sarah Tevis, MD, a surgical oncologist and mentored member of the University of Colorado Cancer Center. For Tevis, instant gratification means curing cancer in the operating room. “As surgeons we like fixing a problem,” says Tevis. “That’s what drew me to surgery. You can treat cancer very definitively.” Tevis told her parents from a young age she would be a physician, but, “I didn’t have a sense of what kind of doctor I wanted to be until I was in high school and my dad developed lung cancer,” she says. “I was old enough to be involved in his care and I got a good sense of how a team takes care of cancer patients.” Then came college, and then medical school at the University of Wisconsin School of Medicine and Public Health. Tevis was halfway through her residency there when she decided to specialize in breast cancer surgery. Her time on the breast service allowed Tevis to meet patients and learn about the research that guides treatment recommendations. She also learned to help patients make treatment decisions based on their life priorities. “I did the breast rotation my third clinical year and really enjoyed the patient population,” Tevis says. “We have great evidence for treating patients with breast cancer and they have a lot of
issues to manage like young kids, time off work, and transportation. I like to help them with everything.” And by “everything” Tevis means not only cancer surgery, but the multitude of issues that surround cancer care, not the least of which are the demands of a continuing life, including jobs and families. Often, the realities of life surrounding cancer mean that not every patient has the same priorities. “I have patients coming to my clinic and I’m thinking about their breast cancer,” says Tevis. “But they are thinking about their 8-year-old autistic son, so their focus is on completing treatment with the least amount of doctor visits or surgery.” In fact, Tevis’s goal to offer compassionate care that takes into account the real lives of patients outside of cancer has led her to make these issues the focus of her research, measuring the impact of cancer on patients’ psychosocial well-being, sexual health, and even cosmetic outcomes. “Patient concerns are very subjective, but we can’t ignore these important aspects of the cancer experience,” stresses Tevis. “Those concerns influence patient decision making and a patient’s ability to go through with all their treatment and achieve the best outcome.” Because cancer can so deeply affect so many aspects of a patient’s life, it can be challenging to identify all the needed supportive resources.
SARAH TEVIS, MD
“We have so many things we have to talk to them about,” she says, “including different types of surgery, the potential for chemotherapy, if they are going to need radiation, and what kinds of medication they will need longer term.” In addition to her surgical schedule and research on supportive services, Tevis is a leading expert in the treatment of a rare type of lymphoma called Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL), which, in rare cases, forms around a textured implant and can travel to other parts of the body. “I’ve seen patients with different presentations of the disease,” says Tevis, who recently published treatment guidelines for the condition. “I’ve operated on patients with the disease and so it’s nice to offer that option to women in this region with this type of lymphoma.” As a surgeon, Tevis can cure breast cancer in some of her patients. And for her, that’s the most gratifying kind of instant gratification.
C3: SPRING 2019
13
