Eradicating the scourge of breast cancer is simply another day at the office for Dr. Leah Gendler. The renowned medical oncologist and breast surgeon spends each of her 14-hour workdays deftly excising tumors in the operating room or counseling breast cancer patients on what should be their next lifesaving move. That’s why we’re honored this Power Figure gave Bare it All so much of her valuable time to share what drives her forward and what gives her hope.
Q: Tell us a bit about you. How and why did you choose to pursue this specialty?
A: I grew up between London and California. My parents are both scientists. My mother continues to have a very successful career and managed to be a wonderful parent to me and wife to my dad. She’s a professor at the Mayo Clinic in Scottsdale, AZ, where she has clinical trials of vaccine therapy in breast cancer patients. She cloned MUC1, which has been implicated in the metastatic process of most cancers.
Breast cancer is a family disease. My mother had breast cancer, as did her mother, multiple maternal aunts and a cousin. I’ve always been interested in women’s rights and women’s health issues. I never would have thought to pursue a career in surgery, but I loved the rotation during medical school and spent over a year trying to talk myself out of it. Surgery prevailed. Breast surgery allows me to be a surgeon and also be in the center of women’s health and lives. There’s an element of preventive health in caring for breast patients.
Q: What’s it like emotionally to deal with cancer for a living? How do you stay strong?
A: Cancer is a very dynamic field. There’s research published every day that affects how we advise, treat and manage the disease. At this point, over 95 percent of breast cancer patients are longterm survivors. I have the honor of framing their diagnosis and care in a positive light; I have the honor of giving hope and even humor during some of the tough moments.
Following patients after treatment is how I stay strong. I’ve found that most patients really embrace life after going through such a terrifying event. They have their mortality rudely thrown in their face, and then they are alive and well on the other side of their treatment, so they live life like they never did before. They don’t sweat the small stuff. They appreciate the day-to-day. For many, life becomes that much richer after having gone through a breast cancer diagnosis.
There are, of course, stories that end tragically. There are young patients with bad diseases who are especially unprepared to deal with a cancer diagnosis. There are also those with minimal or no support structure. These are the patients who need you the most. Thankfully, I have an amazingly supportive staff, including nurse practitioners and breast nurse navigators who can help them negotiate the appointments and the treatments. They meet others actively going through the process or who have already completed their care. They talk and bond with those other women.
Q: In what ways are you helping to turn the tide against breast cancer?
A: By remaining current. By applying the newest research to patient care. By helping both the patient and their families cope and get through their care.
Q: What does your typical day look like?
A: I leave my house between 6:30 and 7 AM. I am either in the operating room all day or in the office. I split one work day a week between the two.
Q: What’s the most challenging part about your work?
A: In the office, it’s delivering challenging news to multiple patients and their families, and giving everyone appropriate time and attention—I have to educate each patient because breast cancer isn’t one disease; it’s likely hundreds of diseases with very different genetic makeups and behaviors. As we learn more about different genome types, we’re able to tailor treatment in a very personalized manner with targeted therapies. The patients must understand their disease and all their varied treatment options. We then make the treatment decisions together.
When I return home, usually after 9 PM, I am exhausted, my family is exhausted and it’s difficult to spend quality time at that point. We really have to focus on the weekends and enjoying all sorts of activities together as a family. I could not do what I do without my incredibly supportive husband. He left his career a few years ago to raise our 7- and 13-year-old sons. I hope my husband will be able to return to a fulfilling career once our sons are more independent. He contributed so much to society as a city planner in NYC before stepping down. We will all benefit if he returns to the workforce one day.
Q: What trends or changes have you noticed over the course of your practice?
A: The most practice-changing development for breast surgeons in recent years is the management of the lymph nodes within the axilla, or armpit. Surgeons have long been able to avoid removing all of a women’s lymph nodes when those nodes are cancer-free. Based on recent research, it’s possible to further avoid full lymph node dissections in specific circumstances for women with low-burden-positive lymph nodes. Fewer women will suffer the negative effects of a full lymph node dissection, including swelling of the arm, decreased range of motion and chronic pain.
Another major advancement is with the development of 3D mammography. These mammograms are extraordinarily sensitive at picking up breast cancer in dense-breasted women. The 3D mammograms will double the cancer detection rate and decrease the number of call-backs and unnecessary biopsies.
The development of oncoplastic techniques in the OR allow the breast surgeon to remove large tumors, remodel the breast tissue and leave beautiful cosmetic outcomes. We frequently work with our plastic surgeon colleagues, especially when we combine lumpectomies with bilateral breast reductions or breast lifts. Reconstruction after mastectomy has also continued to push the limits of cosmetic outcomes—most women are extremely satisfied after mastectomy with reconstruction. Many patients are able to preserve the nipple during mastectomy, and you wouldn’t know they had surgery besides small, peripherally-located scars.
Q: What’s the future of this disease? Where do we go from here?
A: As we learn more about the biology of this disease, I would expect for the research scientists to develop targeted therapies with less toxicity. Vaccine therapy is literally training the immune system to identify cancer cells and attack them before they can spread. We may eventually be able to prevent cancer with such vaccines. Or we will use vaccines in those who have already been treated for their cancer so that if the cancer were to re-occur, the immune system would be armed and ready to kill those cells. We may eventually see a time when we do a biopsy or simply draw a patient’s blood, and we can treat them with a series of injections that shrink the tumors away.
Dr. Leah Gendler, MD, FACS, provides patients with exceptional surgical care for benign and malignant diseases of the breast. A board-certified surgeon at Morristown Medical Center’s Carol G. Simon Cancer Center, she spends time educating patients about their treatment options and is part of an outstanding multidisciplinary team offering highly personal care. Dr. Gendler earned her fellowship from Columbia University Medical Center in breast surgical oncology, is widely published and presents at national meetings on breast cancer-related topics.
Meet all the Breast Cancer Awareness Month Power Figures here:
Read our 2015 series here:
- Part One – You are Now Entering the Third Dimension: 3D Mammography
- Part Two – The Angelina Effect: Genetic Testing for Breast Cancer
- Part Three – Breast Cancer Awareness: Pink is the New Black
- Part Four –
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