When she was eight years old, Doreen Leyden Wiggins ’84 set her sights on becoming a doctor. It mattered little that no one in her family had gone to college; she maintained a steely determination that drove her academic success.
An undergraduate chemistry and psychology major at URI, she received the Academic Excellence Award in Psychology, was a graduate of distinction, and earned admission into Brown University’s Medical School, where she felt “as academically prepared as any of my Ivy League classmates.”
Although interested in oncology, Wiggins trained to become an obstetrician/gynecologist to balance the unforgiving schedule of medical school with the needs of her two young children. After medical school, she established a private ob/gyn practice where she sometimes treated patients challenged by cancer, prompting her to re-examine her professional options.
“I considered a gynecology/oncology fellowship, but that’s a three-year program. The breast fellowship at Women & Infants Hospital in Providence was one year, and that was doable,” says Wiggins. “I felt comfortable taking a sabbatical and leaving the practice in the excellent hands of my partners, who share my patient-centered commitment. I now work part-time in the Center Ob/Gyn, the practice I started.”
Sponsored by the Society for Surgical Oncology, the fellowship admits one physician each year. Chosen among numerous applicants, Wiggins embarked on a journey that involved research and clinical rotations in radiation oncology, medical oncology, radiation, and pathology.
Upon completion, she joined the Women & Infants Breast Health Center where, as a breast surgeon, she is part of a multidisciplinary team providing integrated care to cancer patients. The center is part of the Program in Women’s Oncology lead by Dr. Skip Granai, a nationally renowned gynecological oncologist.
“Cancer centers are everywhere, but at the Breast Center our patients see everyone—from surgeons to social workers—in one place. One of our primary differentiators is the center’s prospective tumor board. Comprised of surgeons, radiologists, and other medical professionals, the board reviews a patient’s entire case before treatment begins.
“We also offer alternatives to traditional medicine, such as massage and animal companionship (via Smokey, an 11-year-old Labrador who welcomed a visitor with wagging tail). The medical community hasn’t tapped into these treatments despite their benefits to patient wellbeing. More than 60 percent of our patients choose some form of alternative care.”
Wiggins and her colleagues are also investigating options to traditional treatment. Women with breast cancer often undergo axillary lymph node dissection—the removal of lymph nodes in the armpit region—and subsequently experience discomforting side effects such as lymphedema (swelling from excess lymphatic fluid) and numbness.
To mitigate those risks, Wiggins is offering another option, sentinel lymph node biopsy. The research seeks to determine if node-positive women could get a sentinel node rather than an axillary dissection. “Sentinel lymph node biopsy is a more targeted, less-invasive procedure. If we can eliminate cancer by removing just the sentinel node [thought to be the first node that cancer spreads to], it’s worth considering,” she explained
Wiggins strives to offer patients choices and to treat the whole patient instead of just the disease. Cancer may be limited to a specific body part, but its impact affects all aspects of life. Women diagnosed with cancer experience a wild range of emotions and feel anxious about its effects on their intimate relationships. To address this latter issue and related topics, Wiggins and her colleague, Dr. Don Dizon, established Rhode Island’s first Center for Sexuality, Intimacy, and Fertility for cancer patients at Women & Infants.
“The need for this program was tremendous,” Wiggins said. “According to the National Institutes of Health, 50 percent of women surviving breast and gynecological cancers cited long-term sexual problems as a result of treatment. Some physicians don’t want to discuss these topics that are at the forefront of our patients’ minds. Some women wonder if they should harvest eggs before treatment; others are concerned about whether disfiguring surgery will interfere with their private lives. As the center’s co-director, my goal is to create an awareness of these issues and offer solutions.”
Another of Wiggins’ objectives is to develop a holistic approach to cancer survivorship. Once treated successfully, patients lose the close relationship established with their comprehensive treatment team. They are no longer monitored as closely and are left to schedule their own follow-up screenings. Typically, compliance wanes. Some patients are afraid to learn they may have relapsed; others simply want a break from doctors’ visits.
“There is no one person who manages post-cancer care. Some patients return to their primary care physician, but they do so as very different patients. I think a more comprehensive cancer management program can benefit these patients, and I think we can accomplish that here.”
Wiggins faces challenges with awe-inspiring enthusiasm. Passionate about exercise, she has completed many marathons, and in 2001 she followed the Tour de France, riding the Alps stages. It was fitting then, that she was one of 26 riders chosen to join Lance Armstrong in the 2003 Tour of Hope, a cross-country journey to promote cancer research awareness.
“Riding with Lance was a once-in-a-lifetime experience. Given my profession and personal connections with cancer—my mom had lung and rectal cancer—I’m supportive of Lance’s efforts to bring attention to the fact that 10 million Americans are living with cancer.”
After reading about the Breast Cancer Fund’s Climb Against the Odds, last year she decided to climb California’s 14,162-ft. Mt. Shasta. To prepare, Wiggins donned a 50-lb. backpack while riding an elliptical trainer and hiked for nine miles in New Hampshire. She enjoys combining athletics and advocacy, remarking that “exercise has always kept me grounded; it’s the time for me to do something for myself.”
Then there is her growing family. Wiggins and her husband, Michael, an orthopedic surgeon, have four children: Steve, 19; Brenden, 16; Kai, 12, and Olivia, 11; and, Wiggins adds, “I am currently pregnant (at 44!) with my 5th, due this June.”
Whether caring for those afflicted with cancer, researching new treatment methods, or testing her physical stamina, Wiggins is always driven by compassion. She is the embodiment of the patient advocate.
By Maria V. Caliri ’86, M.B.A.’92
Photo by Nora Lewis