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Health Matters: Providence St. Joseph Hospital | 5 K athleen Whitcher is used to taking care of things. The 57-year-old is a distribution manager for a cooling and thermal product supplier, so she's very organized. Sure, she tried to keep up with her annual pelvic exams and mammograms but, like many busy people—especially now—put them off a bit and had actually not had a routine physical in about four years. When she got a gynecological exam in 2019, the doctor ordered an ultrasound, which revealed that she had developed fibroids in her uterus, and her doctor scheduled a hysterectomy. Whitcher then got a mammogram, and the doctor reviewing those images saw a spot, but two ultrasounds failed to confirm it. A 3D mammogram finally showed stage 0 breast cancer. She went to see breast surgeon Michele Carpenter, MD, head of the Breast Program at Providence St. Joseph Center for Cancer Prevention and Treatment, who scheduled a core biopsy that confirmed the stage 0 diagnosis. "Stage 0 means it's noninvasive and slow- growing, and is still contained within the milk ducts," Dr. Carpenter explains. "It also meant we had some time; the cancer could be dealt with after the hysterectomy." So she had the surgery, following Dr. Carpenter's recommendation to have everything removed, including the ovaries, "which produce estrogen and could affect the breast cancer," Whitcher recalls. "At first the surgeon pronounced that she saw nothing wrong. Then she came to me with tears and told me the pathology showed cervical cancer. I immediately saw a gynecologic oncologist. The doctor gave me an option: He could take a biopsy laparoscopically, or just assume it's cancer and treat it," Whitcher says. "I said, 'Let's assume it's cancer.' And I got chemotherapy." FIRST TREAT THE CERVICAL CANCER, THEN ADDRESS THE BREAST CANCER Whitcher 's chemotherapy was mild and didn't cause hair loss, but she also had to have 10 weeks of chemo and radiation therapy at the same time. "Kathleen's cervical cancer was significant, and she needed the chemo and radiation right away," Dr. Carpenter recalls. "And because the breast cancer was so low-risk, I didn't see her back until the end of 2020. She came to me and said, 'Let's get this taken care of.' " "Dr. Carpenter gave me the best advice; she told me to be careful about who I told about my breast cancer, because everyone has a breast cancer story," Whitcher says. "She said, 'This is your cancer and unique to you. Just remember that when people give you advice.' " In January 2021, Dr. Carpenter did a lumpectomy. "Kathleen elected to get intraoperative radiation, radiating the affected area while she was still under. The advantage," Dr. Carpenter says, "is that it's convenient, and with a small cancer with low risk of recurrence, it makes sense." "I got very lucky," says Whitcher. She's doing great, exercising and eating well, and has lost 40 pounds. "I've never felt better." The experience has prompted her to be more attentive to her screenings, and she has told her daughters to do the same. She is also now part of Dr. Carpenter's breast program peer counseling team. "I want to tell people about all the amazing technology, including the 3D mammograms." PREVENTION, AGAIN, IS KEY While a simultaneous diagnosis of cervical and breast cancer is uncommon, a dual diagnosis does occur more often with patients who have ovarian cancer. "So when it comes to breast cancer, we continue to state that your annual is vital," says Dr. Carpenter. "We breast doctors recommend annual mammograms starting at 40; if there's no family history or other risk factors, some patients can do every other year starting at age 50." At St. Joseph, the doctors and nurses have weekly tumor conferences to share information about patients and research. "You are always a student, especially when it comes to cancer," Dr. Carpenter says. "You can't think that what you learned in 1989 will stay relevant." To find out more about our cancer center, go to providence.org/sjocancercenter. Double Trouble A diagnosis of breast cancer and cervical cancer was devastating, but the diligent, thorough and innovative work by a team of Providence St. Joseph doctors saved this woman's life. Dr. Michele Carpenter

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