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Woman Of The Year Nominee: Strength And Hope
Dr. Janice Galleshaw and her role in the outcome of a national trial that offers new hope for breast cancer patients
by Judy Lummis McGinnis
June 1, 2006
Your career began in research, including stints at the U.S. Food and Drug Administration in Washington, DC, the Centers for Disease Control in Atlanta, and the Salk Institute for Biological Studies. How did you decide to switch to medicine?
My last research job, at the Salk Institute, was very exciting. I saw graduate students working with renowned scientists from around the world. I also got to see that they worked extremely long hours, were pretty isolated and were not well compensated for their time. I was more interested in working with people. When I started medical school my thoughts were toward running a rural family practice.
When did you choose to focus on oncology and breast cancer prevention?
During the clinical years at school, I realized two things
were particularly important to me: talking with patients and having patient compliance. I like
helping patients understand their disease and contributing to their decisions. Not all doctors are
comfortable with bedside manner but for me it's a strength. The compliance relates to human nature;
people who suffer from a disease like high blood pressure that does not have symptoms tend to not
follow doctors’ orders, which is very frustrating. Patients with cancer, on the other hand, are
part of the process and buy in very quickly.
From a career standpoint, I sought a field that would continue to grow and, sadly, oncology is such a field. Over time, I found I was treating more and more breast cancer patients and decided to make it my focus. The good news is that there is a lot of research going on, a lot of funding, and it's exciting to help solve the problem of cancer. I still feel that we will be able to cure and prevent cancer while I’m still in practice.
You served as the Principal Investigator (PI) in the Atlanta region for the STAR Trial (Study of tamoxifen and raloxifene). What impact will those trials have on breast cancer prevention?
The study found that raloxifene (brand name: Evista, by Eli Lily) cuts the occurrence of invasive breast cancer by 50 percent for post-menopausal women who are at increased risk. There actually has been a breast cancer prevention medication (tamoxifen) available for years, but the side effects have kept women from taking it. The side effects of raloxifene are greatly reduced and we expect that more women will take it and more doctors will prescribe it, particularly because raloxifene is a known medication already used to prevent osteoporosis.
What other insight can you provide women regarding breast cancer prevention?
Besides regular gynecological exams and mammograms, women can check their personal risk for breast cancer at www.breastcancerprevention.com and click on “ Calculate Your Breast Cancer Risk”. It takes less than five minutes. Because risk increases with age, women should check every few years, then, share their results with their doctor.
Also, the field is continuing to progress toward more prevention alternatives. A third breast cancer prevention trial, STELLAR (Study to Evaluate LetrozoLe And Raloxifene), will get underway shortly. (Editor's note: Galleshaw will serve as PI in the Atlanta region for this study.)
What is the most challenging part of your practice?
The best and the hardest parts are closely related: I get to know my patients well, and often we have a close relationship. For many, I am seeing them at the worst time in their life and I offer a ray of hope – a chance for a cure, a longer life [and] a higher quality of life. People always need hope and I try to provide some for all. And, my patients teach me. It is amazing to watch folks grow as they go through the treatment process. The strength of the human spirit is amazing, what people can do that they otherwise wouldn’t expect they could do.
On the flip side, my relationship with my patients means that any loss is awful. I typically do not attend funerals, because they are such a struggle for me. I know things couldn’t have gone differently, but I can’t help rethinking each case. I deal with it by carefully preparing terminal patients for dying, and when I know I am seeing them for the last time, I always say goodbye. After a death, I keep in contact with my patient's family, often calling them months or more later to see how they are adjusting.
Did anyone in particular inspire you in your adult life?
My father. He was a chemist with an amazing mind for whom family was a high priority. His faith was strong and he was very involved with the Methodist church. He was the sort of person whose friends would seek his advice and he could answer any question –I don’t know how, except that he read lots. He always gave us a sense of being well cared for. My dad was very education-oriented and when, shortly before he died (ironically, of cancer) he saw me receive an honorary degree from Oglethorpe when I was the commencement speaker there. I felt it was a gift to him at the end of his life.
