Family House Diaries: Dana DiPerna Pillsbury

Thursday, August 19, 2010 - A breast cancer recurrence yields a serendipitous journey for a high school English teacher from Davidson, N.C., and leaves her with far more than the disease has taken away.

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Written by Elizabeth Swaringen for UNC Health Care

CHAPEL HILL, N.C. – A recurrence of breast cancer has taken high school English teacher Dana DiPerna Pillsbury on a serendipitous journey and left her with far more than the disease has taken away.

“A cancer diagnosis puts you in the flow of another kind of energy,” said DiPerna Pillsbury, 47, of Davidson, N.C.  “But all of these little pieces keep coming together, and I feel like I’ve been placed at the center of a web of love and compassion.”

DiPerna Pillsbury, a single mother of now 14-year-old twins, Sam and Sophie, was diagnosed with stage II breast cancer on Election Day 2004.  That December she had a lumpectomy, followed up by six months of aggressive chemotherapy and five weeks of radiation.

“That was all a life-changing experience, but it left me with more than it took,” DiPerna Pillsbury said.  “It led me to ask ‘what am I doing with my life, what am I doing with my body.’  I became a believer in the holistic approach, and I made some changes in my lifestyle and in my diet.”

One of those changes was returning to the yoga mat, a practice that led DiPerna Pillsbury to find the lump that signaled recurrence.

“For five years I did my regular mammograms and routine check-ups and worked hard at reclaiming my body,” DiPerna Pillsbury said.  “I even changed jobs, going back to my roots and teaching kids at risk rather than the top 10 percent of high achievers.  It was rejuvenating.  I was ready to do the happy dance at my five-year check-up.”

But a few days before the scheduled November 2009 appointment with her oncologist in Charlotte, DiPerna Pillsbury was massaging her arm after a strenuous yoga practice and felt a raised area in her right armpit.

“At that point, I knew my body well enough to just go ahead and call my surgeon,” DiPerna Pillsbury said. “By the end of the next day we knew it was a recurrence in the lymph nodes, and there were abnormal cells in the scar tissue from last time.

“Honestly, that news hit me harder than the initial diagnosis,” DiPerna Pillsbury said.  “I was confused because my Catholic school mentality kept me saying ‘but I did such a good job taking care of myself, why am I getting this again?’”

DiPerna Pillsbury had a right mastectomy in December. Some weeks thereafter a biopsy of a raised area on her collar bone revealed two tumors in her lymph nodes that had not appeared on routine scans.

“Although I received good care in Charlotte and I’m not discrediting my team or the care I received from them, I decided I needed to be seen by physicians who were doing the research and who knew the latest,” DiPerna Pillsbury said.  “I felt there would be different energy among those doing clinical trials and seeing patients.”

Through friends’ referrals, DiPerna Pillsbury landed at Memorial-Sloan-Kettering in New York City.  There, she found the integrative medicines/whole-person approach she had been seeking as well as something more personal and pervasive: hope.

“They had read my charts, knew my whole history and looked me in the eye when they said ‘this is what we recommend, what do you think?’ ” DiPerna Pillsbury said.  “It was a very different approach to my health and healing, and I was energized.”

And they were not hesitant to refer DiPerna Pillsbury to Lisa A. Carey, MD, medical director of the UNC Breast Center and co-leader of the Breast Research Program at UNC Lineberger Comprehensive Cancer Center, which has the longest continuously running Specialized Program in Research Excellence in Breast Cancer in the country.

DiPerna Pillsbury Googled Dr. Carey and sent an email directly to her.  “It was one of those ‘you-don’t- know-me, but-I-hope-to-work-with-you-and-here’s-my-story emails,’” DiPerna Pillsbury said.

The following day DiPerna Pillsbury received an email reply from Jami Linn, the nurse navigator in Dr. Carey’s office, and the mother of BethAnne, one of DiPerna Pillsbury’s former students, who had also babysat for Sam and Sophie years ago.  Immediately, DiPerna Pillsbury knew she was supposed to be in Chapel Hill, and within three weeks was meeting with her team led by Dr. Carey.

(DiPerna Pillsbury’s team also includes Keith D. Amos, MD, assistant professor of surgery; Jan S. Halle, MD, associate professor of radiation oncology; Catherine A. Fine, MS, CGC, clinical assistant professor of genetics; and Holly Hough, PhD, research associate with the Comprehensive Cancer Patient Support Program at UNC Lineberger Comprehensive Cancer Center.)

“I love them all, and I am blown away not only by their intellect, but by their compassion for patients and their passion for their work,” DiPerna Pillsbury said.  “Their ability to explain exactly what was happening gave me enough information that I could be an active participant in my own care.  I felt comfortable, empowered and safe.  To the person, they continue to make me feel like I am part of something bigger, that the things I’m doing at UNC Lineberger will benefit other women who find themselves in this place, too.”

Dr. Carey believes unquestionably that the multidisciplinary team approach offered at UNC Lineberger gives cancer patients the best support in understanding their disease and the choices for treating it.

“Patients are looking for guidance and it’s important for them to understand what we are recommending as next steps and why,” Dr. Carey said.  “By having a team that represents all modalities of care and supportive care, we offer an integrated approach that helps the patient see the big picture and simultaneously tease out specific questions and concerns – and get answers.  It’s a way to help patients feel in control when so much in their lives feels out of control with a cancer diagnosis.”

The successful integrative approach hinges on a close-knit relationship among the medical professionals, Dr. Carey said. “We genuinely like and respect each other. I have faith that my colleagues will think hard about what’s best for the patient, and that we all are committed to open, two-way communication.”And the commitment to two-way communication throughout the team allowed DiPerna Pillsbury to be a teacher, even as a patient.

“The radiation therapy necessitated that I wear a custom-fitted mask to protect my thyroid gland, face and head and to make sure I didn’t move the few minutes the radiation was targeted at the tumors,” DiPerna Pillsbury recalled.  “From the chemo I was having hot flashes and my nose was stuffy and when I first lay down and put on the mask, which was then bolted to the table, I almost panicked,” DiPerna Pillsbury said. “I made it through that experience and afterward, my nurse Dee and the technicians were extremely receptive to my feedback.  It was a teachable moment.

“They explained exactly what was happening so that I could meditate or visualize the radiation working,” DiPerna Pillsbury said.  “I chose to think not in terms of battling my body, but helping my body return to normal.  These are my cells that are misbehaving, and I want and need to think of peaceful ways of restoring health to my body.”

DiPerna Pillsbury wrapped up four months of post-mastectomy chemotherapy in Charlotte in May, and then spent four weeks Monday through Friday in Chapel Hill receiving a different chemotherapy and twice daily radiation. The tumors near her collar bone have shrunk, and surgery to remove them is scheduled for September.  She plans to be back in the classroom for the fall term at Hough High School.

While in Chapel Hill for radiation, DiPerna Pillsbury stayed at SECU Family House, a 40-bedroom hospital hospitality house minutes from UNC Hospitals.  Family House provides comfortable, convenient and affordable housing for seriously ill adult patients and their family member caregivers.

“I purposefully chose Family House after the volunteer who gave me the tour talked as lovingly about the house as if it were her own,” DiPerna Pillsbury said.  “It’s convenient, and I knew I could always get to the hospital easily thanks to the shuttle.  Careful attention is given to making sure the Family House experience is comfortable and peaceful. It’s like a nice hotel only better.”

DiPerna Pillsbury admits she was initially a bit reluctant about the communal kitchen and dining areas, but those features of SECU Family House have been one of the most significant pieces of the whole journey.

“I’ve met some amazing people who are incredibly inspiring to me,” DiPerna Pillsbury said.  “I was there with families as well as patients, and often times it’s the families that need as much if not more support than the patient.  You’re at a helpless place when a loved one is sick.

“I didn’t want to be thinking about my own situation all day, and I was able to open up to other people and just listen to their stories.  I felt very lucky to be focusing on others rather than myself. When this is all behind us, I want to find a place like Family House where we can go as a family and give back.  It’s important for my kids to hear and see what happens here.”

From her very first day at SECU Family House, DiPerna Pillsbury knew she was supposed to be there.“It was nearly dark when I arrived, and as I pulled into the parking lot, there was Luis, the night manager, standing at the window as if he were watching just for me,” DiPerna Pillsbury recalled.  “The porch light was on.  It was like finding a lighthouse, a joyful, calming beacon in the midst of a very turbulent, sobering experience.”

Ever the teacher, DiPerna Pillsbury continues to find meaning in her journey and all the great and brave things she’s witnessed along the way.

“I’m trying to pay attention and take very good notes,” DiPerna Pillsbury said.  “For now, I am in very good hands.”

Media contact: Tom Hughes, 919-966-6047, tahughes@unch.unc.edu