A multi-cancer survivor is joined by two oncologists from her care team to talk about what it took to beat metastatic breast cancer.
In this special live episode of Health Matters for Breast Cancer Awareness Month, Courtney Allison sits down with Kiley Durham, a mom, artist, and multi-cancer survivor. They discuss Kiley’s cancer journey, and invite two doctors from Kiley’s care team to join their conversation and reflect on her treatment. Dr. Tessa Cigler, a medical oncologist, and Dr. John Ng, a radiation oncologist, celebrate Kiley’s resilience and how she beat the odds. They also talked about their approach to cancer care, which doesn’t just treat the disease, but surrounds each patient with everything it takes to fight it.
Courtney Allison: Welcome to Health Matters, your weekly dose of the latest in health and wellness from NewYork-Presbyterian. I'm Courtney Allison.
For Breast Cancer Awareness Month, I had the privilege of sitting down with Kiley Durham, a mom, artist, and multi-cancer survivor. We recorded our episode in front of a live audience as part of an event called the Art of Healing. Kiley shared her moving story, including the important role that art played in her cancer journey. Two doctors from her care team at NewYork-Presbyterian and Weill Cornell Medicine joined our conversation.
Dr. Tessa Cigler, a medical oncologist, and Dr. John Ng, a radiation oncologist, reflected on Kiley’s resilience and how she beat the odds. They also talked about their approach to cancer care, which doesn’t just treat the disease, but surrounds each patient with everything it takes to fight it.
It was a powerful evening of conversation and it’s a pleasure to share it with you now.
Welcome everyone to the first live episode of Health Matters. We are so glad you're all here. And Kiley, we're so glad you're here.
Kiley Durham: Oh, the honor’s mine. It's great to see all of you guys tonight.
Courtney Allison: Before we dive into your cancer journey, tell us a little bit about yourself. What brought you to New York?
Kiley Durham: I moved to New York when I was 22 years old to work in fashion. And it was really like a dream come true. I moved here, met the boss of my dreams, who's in the audience tonight and worked with the team of my dreams and loved every minute of it, designing dresses and just living the city girl life that I dreamed of growing up in the South.
And from there, actually 20 years ago this week, I met my husband. And we got married and we had kids and before we knew it, we had been here for 20 years.
Courtney Allison: Oh my gosh, it goes so fast.
Kiley Durham: Yes.
Courtney Allison: So, you met your husband, you had your children, and now it's 2017 and you felt a lump in your breast.
Kiley Durham: Yes. I was pregnant with, or I had just given birth to our second child.
Our son was five and a half, and starting kindergarten very soon. And our daughter was three months old. And I guess to back up before that, at my eight week appointment with my OBGYN, I said, you know, I feel something in this breast. I think it's breastfeeding related, but could you look at it?
And he just really urged me to, you know, not guess and to get an ultrasound. And it was fairly evident from the ultrasound that it wasn't breastfeeding related and a biopsy the next day confirmed that it was breast cancer. So, I had a three-month old and I had breast cancer.
Courtney Allison: I know you've talked about how hard it was waiting for that call.
Kiley Durham: Yes. So the timing sort of fell over the weekend, so we had this very long, drawn out weekend waiting to hear back from my doctor. And you know, with small children, we were trying to keep the house as normal as possible. We got up early, we went for a walk to the park, we did our family dinners, we did all of the things we do on the weekend.
And then Monday came and we knew the call was coming that Monday. And you know, I, we were trying to be busy. I cleaned the house more times than I could possibly think of. And we just thought all day, you know, when is he calling? When are they calling? We just want this over. And then the phone rang.
Um, and all I could think, you know, in those five seconds it took for me to answer the phone, put it to my ear, I want it, I want it back. I want the weekend back. I want one more walk. I want one more pizza. I want one more middle of the night feeding with my newborn. I want just one more day of normal before they tell me what I think I already know.
It was, you know, heart racing, throat tightening. Just all of those feelings all at once. And then he said the words that I just never imagined I would hear in my life. I'm sorry, it's breast cancer. And our world just flipped in a nanosecond.
Courtney Allison: And so how did you find Dr. Cigler, who we look forward to bringing on later tonight, and what was that first visit like?
Kiley Durham: So, initially, I walked into her office and the first thing she said was, We need to talk about your hair. I had, still had very long, big hair from being pregnant. And you know, I was going to be on chemo.
And so she said, We really need to talk about your hair. And my husband said, Let's talk about the treatment first. We'll get back to the hair. And she said, no, this is very important to her. She is about to have a lot of things change. Let's do something to make it easier. And so we talked about the wig and where I should go.
And it was just the most human, empathetic moment in the middle of a season that became very scientific. I was hearing about, uh, medications and side effects and blood counts and I had never had an MRI in my life and all of a sudden I was having them all the time. And to sort of pause that for just one little second and be so incredibly human was so comforting and really helped me through.
And helped me, I think, to even trust her because she was so kind in that very first meeting.
Courtney Allison: So you mentioned chemo. Can you talk about the little advice that Dr. Cigler gave you ahead of it.
Kiley Durham: Chemo is a very long road. It's, there's not any other way to say it than that. It's exhausting. It's draining, and if you, you know, like for me, I had two very small children that I was trying to take care of when I could. It was difficult. Dr. Cigler knew that was coming, and so she called me.
We had been in just, like, overdrive the week before I was starting chemo, trying to organize the house, and make sure the kids had what they needed, and those sorts of things. And I was actually on my way back from the grocery store for like the tenth time. The day before, or the weekend before I started chemo, and Dr. Cigler called me that, it was like 6 o'clock in the evening. And she said, what are you doing? And I, I said, I'm, I'm, you know, getting organized and everything. She said, okay, stop. Just rest. Delegate. I know you have people here to help you, and it's time for you to rest.
So I want you to just rest. Just go home and rest for the rest of the weekend and come in ready to start this next week.
Courtney Allison: It's time for you to rest. I love that. And so you mentioned you're breastfeeding, you're only 36, you're a young mother of two young children. What was it like navigating this illness, you know, on top of parenting and with your children?
Kiley Durham: Oh gosh, I mean, it's, it's exactly what it sounds like. I think we had to have some very candid conversations with our five year old, almost six year old, you know, mommy is going to take some medicine that's going to make her feel different. It’s going to make her act differently. She's going to look really different and if you're ever embarrassed by it or uncomfortable by what you see, please just tell me.
And so, he, at first he said, I think I'm okay with it, and then later, I think when I was tucking him in for bed that night he said, Would you mind wearing your wig when you come to school? Um, he said I think it should just be our secret. So, it was just our secret. So, the first day I ever wore my wig was to his first day of kindergarten.
Courtney Allison: And you also rediscovered art through this.
Kiley Durham: Yes!
Courtney Allison: Can you talk about the moment art came back into your life and, you know, how it helped in your healing journey?
Kiley Durham: Yes, um. I might cry now. [Laughs] I have painted my whole life. I really wanted to go to art school. I ended up majoring in design, which was absolutely the right thing to do.
But art and fine art, especially, always just held a very special secret place in my heart. I can remember, my earliest memory is painting at our kitchen table when I was a child. And you know, at some point life was too busy. You have children, you move on. You think that's just a childhood passion and you sort of move on.
One day I woke up from a very long chemo nap, and there was a box on our kitchen table, and my mom said, a package came for you, and I went over, and it was full of art supplies, and I just, I, I didn't order it, I didn't know what it was, and she said, It's not too late, I don't know what you're waiting for.
So, she was like, let's, you should do this. So after a lot of coaxing we sat down at my kitchen table and we started painting together almost every day. And that is how I got through chemo, for sure.
Courtney Allison: That's so beautiful, it's not too late. Your mom is awesome.
Kiley Durham: She is!
Courtney Allison: So going back to some of the clinical pieces. For a little while it seemed like you might be in the clear, but then you started getting some headaches.
Kiley Durham: Yes.
Courtney Allison: Can you walk us through what happened next?
Kiley Durham: Yes, you know, I think I finished chemo, I had my mastectomy and was, there's like a little interim period where you're healing after your mastectomy and before you can start radiation. And people had told me that, you know, after chemo and after I heal from the mastectomy, I should really feel like a bump in my energy and I should feel a lot better.
And I just really didn't. I felt very tired and fatigued all the time, and I was having these headaches. And over time, those headaches became a little stronger and a little more pronounced. And then the week we were moving into our new apartment I had convinced my mom to come out because at that point I had already started radiation. All of these things were happening and I mean that was enough to have a headache.
And I actually thought that maybe it was just stress. Maybe I was just really tired. And that afternoon we were having a late lunch and my daughter was sitting in my lap and we were being really silly and we were just laughing and playing. And all of a sudden I started having a headache and I can remember saying to my mom, take her, take her, take her, take her, take her.
Something's not right. Something's not right. And I don't remember, really, anything after that. I just blacked out. I got very sick and I blacked out. And the next thing I know is I'm in the back of an SUV. Because we decided it was faster to get to the hospital that way to get in, try to get an ambulance all the way downtown.
And I was in, and I was in the emergency room, they ran quite a few tests and we were waiting and really the only, I have a couple of very specific memories of the emergency room, but what I really remember is the attending walking towards me after I had taken, I finished my round of scans. And she had the most empathetic look in her eyes.
I knew, I knew what she was coming to tell me. And it was just like that same feeling, like when my doctor called me on the phone. It was like it was in slow motion but fast all at the same time. And the next thing I remember hearing is, You have a large tumor behind your left eye. And that's what's causing these headaches.
And then I see my mom and sister basically on the ground crying, you know, because it was just the worst. It was the worst case scenario. And I was immediately admitted into the hospital and prepped for surgery. And I met Dr. Rohan Ramakrishna through that. He was my surgeon.
And you know, you know, five days later I came home from the hospital after having brain surgery.
Courtney Allison: Wow. And then you felt good for a while, right?
Kiley Durham: I did. I did. Yeah, I mean it definitely, it wasn't perfect. We had a few other small mets, a couple of other small mets we had to deal with, but for the most part, I was doing a lot better after that.
And all, I mean, a little more than a year later my husband and I traveled to Italy to celebrate making it an entire year without anything else. And had the best trip. We still think of it as just one of the best trips we ever took. We were so happy. I came back home. I went to Georgia to pick up our kids because our parents were keeping them for us.
And I was really tired. And I just thought, you know, this is the first time I've traveled internationally since I've been sick. Maybe it's just catching up with me. I'm a little more jet lagged than I'm used to being. And then the day before I was supposed to leave, I called Dr. Cigler because I woke up that morning and I just knew it wasn't just jet lag anymore. Something was not right.
And so, in the back of my mom's yard, I'm on the phone because I don't want anybody to know that I’m calling my doctors and she said, Okay, this is what we're going to do. Make up some story and convince your mom to fly back with you. I don't know if you remember saying that, but you were like, you need someone to fly back with you, but just like, don't scare anybody. Just figure out a way to get her back.
It was my sister's birthday. So it was like the perfect ruse. And so I tricked my mother into flying back with me to help with the kids, and we went straight to the doctor. From there we decided to push up some scans I had coming. This was the summer, so everybody's on vacation and people are coming and going.
So we put in the orders for those scans, Dr. Cigler leaves for a trip that she's been planning forever. Um, and this woman never travels and never takes any time off. And so, of course, like, this was the one time. And I quickly did the scans. I think I did them, like, the next day. And then we got out of the car and we drove to Long Island for our last little family vacation of the summer before school started.
And as soon as I got there the doctor that was watching after my case while Dr. Cigler was on vacation, called me and she said, you've got to come back. She didn't even say let's schedule an appointment. She said, you need to come back. And I was like, I’m at the beach right now and I, you know, we're having our, can we do this next week?
She was like, You really need to come back. So, again, this thing that sort of runs through my story is that my entire family literally dropped everything and drove out to Long Island to stay with my kids so that we could leave first thing the next morning to come back into the city to repeat the scans and to meet with the doctor.
And unfortunately, those were the scans that confirmed that I had Leptomeningeal disease and I had cancer in my cerebral spinal fluid. And, you know, you think that you have a brain tumor is the worst thing you're ever going to hear in your life. And then you find out that brain tumors are not so bad.
That there are, there are things that you can do there. There are tricks, there are drugs, there are surgeries that work. And then you hear that, You have sort of rogue cancer cells multiplying in your spinal fluid and there's really no way to get to it. And there's not really anything you can do.
And, you know, I had a two year old and a seven year old running around on their bare feet in the backyard of the house we were staying in in Long Island, having the best summer ever and sending us selfies of their happy time. And that was the first time I cried at the doctor's appointment. I cried with Dr. Ng. I was sitting with him. And we all had, we all had tears in our eyes. And I kept pushing him, wanting to know more. Like, you know, how long do I have? You know, is it what I read on Google? And he refused to answer the questions. He said, let's just, let's just put our heads together. We're going to do something.
And so they swept me into spinal radiation. Which is, I think, you know, backing up, I will say that one of the amazing things with my doctors is that I have such a good trusting relationship that when we had to move at the speed of light to stop this thing, I could trust them to just, what they wanted to do was, you know, we were comfortable with because we knew that they had had my best interest at heart the entire time and we had always had a very open relationship.
So he recommended radiating the spine, but what we did that was a little different than what other doctors would have recommended is that he really tried to isolate the areas where the cancer cells were populating in hopes to ease my side effects because there are quite a few side effects from radiating the spine.
And from there, about, I guess about a week later, we started an oral chemo called Xeloda, which I actually took for four years. And there were some conversations out there about a type of drug called immunotherapy that had had a lot of success in lung cancer, various types of lung cancer.
And it was very close to being approved for various purposes with breast cancer, but it had not been approved yet. But my doctors really felt like it was worth it to see if I could take it. And I don't really know what they did, but they got me approved like that. And so after, you know, I think about a month later we started immunotherapy.
Courtney Allison: So you mentioned that you were off treatment now. Can you talk about how you and Dr. Cigler came to that conclusion and what she said to you in the office that day?
Kiley Durham: You know, they, again, going back to our very good relationship, I think over the course of time, if I said I wasn't feeling well or I was very tired they knew, they knew me well enough to know what I meant.
And so from time to time they would let me take like a little, a little break, maybe a few weeks off of the chemo so that I could just catch my breath and regain a little energy. But over time, those breaks were not helping me anymore. And I just felt like I was scraping the bottom of the barrel every single day.
And wanted to go to bed before we were putting my toddler to bed. You know, it was just a really, it was very difficult to live that way. And she really saw that and understood that. And she said, I think, you know, we've kept you alive all of this time. And now it's just time for you to live. And so we decided to try to go off treatment.
Which is an incredibly scary thing when you've already beaten the odds with something that's not considered treatable. And we treated it, and it worked, and it's terrifying to come off. And so, you know, you can imagine I had to ask her, what happens if it comes back? And she simply said, we'll treat it.
Courtney Allison: So I'd love to ask you one more question before we invite Dr. Cigler and Dr. Ng up here. As someone who has been through so much, what are some lessons you would maybe share with the audience, or anything about your mindset you can tell us?
Kiley Durham: I, you know, well first, when I was first diagnosed with cancer, I just was trying to power through it. I was trying to just get it over with and get back to life, and do all the things I wanted to do. And we would say, we would try, David and I would try all the time to like, try to figure out the timeline.
You know, like chemo takes this long, then you do a mastectomy, then you have reconstruction. It's like, you know. And then you'll be back to normal. And that doesn't work. That doesn't work in anybody's life. I mean, it doesn't work with chemo or cancer, but it's not really real life anyway. And so I think that I learned a lot about just rolling with the punches and making the best of what you have in front of you.
I think later after the LMD, I learned even more about making the most of what you have. Being present every day, being happy and grateful for what you have in that moment and not really worrying so much about the bad things. Our days are numbered. It doesn't feel like it.
It felt like it for me because we really did think that my days were incredibly numbered. But the truth of the matter is, none of us, not one of us knows what tomorrow holds. And so I just decided if I was going down, I was going down fighting. And that I was going to live a happy life for three months or 300 months or, you know, whatever the day is. And I think I would just encourage everybody to live that way. It's way happier than sweating the small stuff.
Courtney Allison: That is such great advice. Thank you, Kiley. This was incredible. We'd love to invite Dr. Ng and Dr. Cigler to the stage now.
[APPLAUSE]
So welcome Dr. Cigler and Dr. Ng. To start, can you please introduce yourselves? We'll start with you, Dr. Cigler.
Dr. Tessa Cigler: Oh, sure. Tessa Cigler. I'm a medical oncologist and I specialize in breast cancer. And Kiley and I have grown up together in a way. Having known her for so many years now.
Kiley Durham: Yes.
Dr. Tessa Cigler: And it's, I always say that, you know, Kiley just brings out the best in everyone. And so it's just a real honor to be sitting next to you today.
Kiley Durham: Thank you.
Courtney Allison: And Dr. Ng?
Dr. John Ng: I'm John Ng. I'm a radiation oncologist. I specialize in breast cancer. And, and thank Kiley and everyone here. Just hearing that story brought back a flood of memories and just makes me realize what a privilege it is when you get to be that intimately involved in other people's lives and Kiley, you're just amazing.
Kiley Durham: You guys are amazing.
Courtney Allison: Dr. Cigler, can you share about your first meeting with Kiley? And also maybe just your first meeting with any patient going through cancer, what you're hoping to convey.
Dr. Tessa Cigler: Yeah, so the first meeting is, I mean, it's always, it's a lot.
And I think women newly diagnosed with breast cancer are, no matter what stage of life, what age, what the degree of severity of the cancer. It is as Kiley said, it's life changing in a minute. And it's incredibly difficult to, in that, you know, 45 minutes or an hour to sort of describe the logistics.
But also somehow inspire confidence and be reassuring, but be also realistic. And it's a lot of parts and a lot of pieces.
Courtney Allison: Dr. Ng, how about you? What are you trying to convey when you first meet a patient who's going through cancer?
Dr. John Ng: Yeah, Tessa brings up all of these essential elements.
I often have a line that runs through my mind before I see patients which is that very famous line in literature that, in the middle of our life's journey, I find myself in the dark forest where the straight road was lost. And and when Kiley was bringing up this, these stories again, just reminds, reminds me of that.
And the reason why I tell myself that is that for a doctor, it's a very busy day, but for the patient, this is the crisis of her time. And to just remember that moment that we're trying to orient ourselves again after a diagnosis. And just realize that this is, and that's what you were talking about, the moment. This is the moment that's so important to the patient. Let's sit down and work this out.
Courtney Allison: You've also mentioned treating with your heart, not just your head. Can you elaborate on that?
Dr. John Ng: Yeah, so you treat with your heart, not your head sometimes because yes, you can, you run through taking care of patients. And then you have a busy schedule and there are realistic constraints. But there are lives, not just the person in front of you, but entire families of lives. And you have to be able to just realize that this is the person in front of you.
What's important to her and to just take the time to think about that. That’s what I mean by treating with your heart.
Courtney Allison: And Dr. Cigler, we heard so many examples tonight of the human element of care in your care of Kiley. Is there anything you want to elaborate on that human element of care?
Dr. Tessa Cigler: I would say that, you know, the greatest gift of being a physician is making connections with people. In my field, you know, I meet just the most incredible women all the time. But each person is different. And I think it's making, important to make those connections and really understand what each woman needs.
But the human touch and how it's presented is, takes a lot of thought and work kind of in the moment.
Courtney Allison: And I think in so many ways, Kiley's story is so amazing. Can you talk about how the team came together to treat her? And either one of you can answer that.
Dr. Tessa Cigler: We got a lot of advice and a lot of opinions and I mean it really it took a village. And we didn't, it took a village. We did not take the responsibility lightly.
Dr. John Ng: Tessa's being really kind here. I think in terms of flashes of memories in one's mind, I still remember these moments.
I'm in the clinic and I get this call from Tessa and I'm like, Isn't Tessa away? And I'm picking this up and Tessa's like, John, we have to talk and you can't believe who it is. And Tessa has a style when she does this.
Dr. Tessa Cigler: I sound very bossy tonight.
Kiley Durham: In the best way!
Dr. John Ng: And those are the fragments that I can remember, discussion, but we're not going to keep everyone here for that.
But that's the nature of, first, you know, at a very personal level, why Dr. Cigler is a great doctor. But also a lot of how wonderful doctors at New York Presbyterian work. We will call each other on the cell phone at that moment. It doesn't matter. You're somewhere, they're just those moments that you have to be able to communicate and coordinate.
And, and Kiley, I still remember that phone call.
Kiley Durham: That was just a phone call. I don't think any of us were expecting that phone call. It was but I will say just, there's a huge, there was a huge, just, collaborative effort among all of my doctors. Even the ones that maybe I had not seen for a while, and the whole hospital, like you said, I feel like the whole hospital was working on it at one point.
And that's really one of the lovely things about New York Presbyterian was that at every turn, every time there was, you know, new bad news or a more complicated side effect than we had planned, there was a doctor. Dr. Cigler found me a doctor every single time, and it was, it was great. I wasn't chasing referrals. I wasn't, you know, sort of in the dark, like trying to figure out what to do. They always had someone there for me.
Courtney Allison: In terms of specifics, Dr. Ng, what role did radiation therapy and immunotherapy play in her care?
Dr. John Ng: Yeah, so, like, Kiley brought from the patient's perspective, I'll try to present a little bit from the clinician's perspective.
Particularly, in the middle story where she is diagnosed with Leptomeningeal disease. It's a very serious condition. And can be sometimes rapidly progressive. And we had to discuss this, she was having some lower back pain and radiation in that setting really usually helps with symptoms. Tries to slow down progression of disease.
But in talking with her we really tailored something because it was on Labor Day weekend and we're doing this and we said, okay, we'll treat a limited area. But at the first sign that anything changes, we'll, we'll change course. To be… it's the magic of Dr. Cigler, the systemic therapy worked beautifully and of course we wish it happens very frequently.
Courtney Allison: So Dr. Cigler, has Kiley’s journey taught you anything? What does her story talk about the future of cancer treatment? And what are you excited about for the future of cancer treatment?
Dr. Tessa Cigler: I think Kiley is the message of hope. And hope for everyone, no matter what the diagnosis, what the prognosis, what the odds are. And I think, Kiley, what you said about, nobody knows. And even though it's the most impossible thing to do and you have done it so well, but the goal of trying to live in the moment.
Courtney Allison: Yeah, absolutely. So I think it's clear, the bond Kiley feels with you both. How does it feel to see patients like Kiley thriving today?
Dr. John Ng: In weeks or months, there'll be another patient with a very similar story and she'll be going, what is this going to mean for me and she'll hear about your story and she'll say, yeah, this is how we're going to beat this. This is how we're going to do it. And that's why I just, it's a great story. It needs to be, needs to be told.
Courtney Allison: Dr. Cigler, how does it feel to see patients like Kiley thriving?
Dr. Tessa Cigler: Kiley is, to me, just a reminder of the incredible privilege that comes with being able to do what I do.
And at the same time, the big responsibility. And it just, the notion of hope and resilience and grace really just is, it's the best part of my job.
Courtney Allison: That’s wonderful. Is there anything you want to add or Kiley, anything you want to share talking with your doctors?
Kiley Durham: I think as far as the doctors go, I think sometimes especially at a high level when you're talking cancer or other very serious diseases, I think there's this sort of idea of you know, sort of a removed feeling you have about those doctors, because it's a very serious thing they're doing.
But the amazing thing is that they're doing this incredibly serious, compassionate thing with so many patients every single day. And then they go home, and they're fathers, and they're mothers, and they have aging parents, and they have, you know, relationships that they're fostering, and children that they're taking care of, and groceries that they have to buy and all of these things and they still have, you know, they are giving up a lot of that time to be there for women like me and people like you guys.
And you know, it's just a really special thing that you guys decided to do.
[APPLAUSE]
Courtney Allison: Our many thanks to Kiley Durham, Dr. Tessa Cigler, and Dr. John Ng.
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