Standing Up to Cancer

Photograph by Julie Bidwell
Above: Dr. Shieva Ghofrany, a few weeks after completing treatment and back to work at Coastal Obstetrics & Gynecology

Last October, Dr. Shieva Ghofrany, bald after chemotherapy treatment for her stage-two ovarian cancer, used her new look as Halloween inspiration and dressed up as Dr. Evil from the Austin Powers flicks. “It seemed that my bald head was the perfect accessory,” she says of her homage to Mike Myers’ iconic character. “I couldn’t resist.”

From a decision to ditch what she called her “Kardashian wig” to the fiercely optimistic “Cancer, I Won’t Miss You” monologue she posted on YouTube after completing chemotherapy at Stamford Hospital’s Bennett Cancer Center, the forty-six-year-old obstetrician and gynecologist has confronted her cancer with honesty, grace and occasional doses of humor.

“No one wants to have cancer, but the most dominant emotion I’ve had is gratitude,” Dr. Ghofrany—Shieva to her patients—says in her office at Coastal Obstetrics & Gynecology three weeks after her last chemotherapy cycle. “Cancer can be instructive, and it’s taught me a lot about how I think we doctors and patients need to deal with it.”

Committed to having her experience help others, the Rowayton resident says: “I feel I’m the messenger, that we all need to be better about self-care.”


In Her Own Words

Why self-care, awareness and a positive attitude matter

It opens eyes to symptoms
“The chief [sign] for me was extremely painful periods. I thought they were related to my history [of endometriosis], and while that’s definitely something that could have been to blame, it had to be investigated. What I was experiencing wasn’t normal, and the message is that you can’t let these things go; [in] my case the cancer was caught at stage two, which is often not the case with ovarian cancer.”

There is no diagnostic test
“[It] is why any kind of vague lingering symptom needs to be investigated. Until they can come up with a marker, where they can find this cancer in our blood, it’s on us to be vigilant. Any kind of lingering abdominal pain or bloating that lasts for more than a week needs to be explored. If a patient tells me that, I’m sending them for an ultrasound right away. It can’t be overlooked because early diagnosis is critical.”

There are different kinds
of ovarian cancer “Mine began because of my endometriosis—it’s a specific kind of ovarian cancer related to that—and I want to stress that it is extremely rare. I don’t want women who have endometriosis to panic and think they are going to get ovarian cancer. The clear majority are not.”

Diagnosis need not be a death sentence
After undergoing a hysterectomy and chemotherapy treatments, the five-year-survival rate for women treated for stage two ovarian cancers is 90 percent. “I will have to be screened regularly for five years, but I’m incredibly optimistic. And that’s something I want people to hear. Ovarian cancer isn’t a death sentence, but a lot of people think it is because so often it’s diagnosed in later stages, when it’s a much more challenging disease. And even for women with stage three and four, the odds have improved. We still have a long way to go, but overall the picture looks brighter.”

Awareness leads to increased optimism
“It’s always been my nature to be an optimist, but now I believe it’s imperative to see things this way. Every day, as a physician, I see people experiencing things that are much more difficult. Everyone has their stuff going on. I’ve never thought, ‘Why me?’ In fact, I think it’s bad for my health to indulge [in self-pity.] I’m a great believer in the mind-body connection.”

A positive outlook promotes improved eating habits
“A few years ago, I had a gastric bypass. My weight had ballooned. My [rationale] before that surgery was that I worked hard caring for my patients and if I wanted to indulge, then [food] would be my vice. Because of the [bypass] surgery, I was already eating differently but I was starting to go back to my junky ways. [Diagnosis and treatment] changed my whole attitude about what goes inside my body. I don’t want it to be a toxic place for cancer to live.”

What Dr. Ghofrany eats today is “an organic, plant-based diet of mostly vegetables and a little bit of fruit. I eat very little processed food, not too many carbs. When I have protein, I usually go for grass-fed beef or wild-caught fish. I’m huge on making healthy juices packed with veggies. We’re supposed to get ten to twelve servings of veggies a day and who does? But by making juices, I can sip all day and I’m good.”

left: Dr. Ghofrany, sporting her signature smile
right: Enjoying the holidays with her husband, Charly Sahlia, the kids and two new additions to the family

Self-advocacy is key
“No one told me to drink these juices or focus on nutrition—or try things like acupuncture for pain—but I’m convinced it’s why I did as well as I did managing chemotherapy. It’s no one’s fault I wasn’t told to do these things and I had to figure them out on my own. It’s an issue with what’s happened to medicine in general. Doctors and nurses are too busy and too stressed these days to focus on putting together these little pieces that I believe are game-changers for cancer patients.”

There are no rules to coping
“I got a wig from this amazing woman in Fairfield. It is the most beautiful wig. But when the time came to put it on, it felt like I had Kardashian hair. It was so long and luxurious and incredible, but it didn’t feel like me and I didn’t feel like I was being authentic. So, I had my husband help me shave [my hair off].”

The reaction? “Sometimes you get the sad eyes. People often assume I have cancer; it’s a conversation starter. It gives me an opportunity to talk about ovarian cancer. I actually love my bald head. It’s so easy and I kind of like the look. It’s edgy and cool.”

Editor’s note: At press time, Dr. Ghofrany had decided to let her hair grow out “just a bit.”

Parents find ways to talk to their children about cancer
“[My] kids have been really resilient, and I think it’s because we broke it down into parts they could understand,” says Dr. Ghofrany, of her three children, who range in age from six to thirteen. “We were very up-front about some things like, ‘Mom is having surgery today and she’s going to be home for a while so she can get better.’ I think they are getting to see that there are two sides to cancer. Yes, some people have terrible experiences with it. But some people don’t and that’s important to understand, too. It makes it a little less scary to hear the word cancer when you understand it can be survived.”


FRIENDLY ADVICE
Has someone you care about been diagnosed with cancer? DR.GHOFRANY offers a couple of tips on how to be a friend to someone undergoing treatment.

An Encouraging Note
“After my surgery, my house looked like a funeral home, there were so many flowers. People have been so kind, but the thing I found most helpful were the texts and emails with messages of encouragement. I get gifts every day from my patients and that’s amazing, but it was those messages that I felt in my heart.”

Please Don’t Cry
“I’ve had patients cry when they see me. My bald head is startling and I know it’s because they love me, but then I end up comforting them and having to insist I’m going to be okay and I’m not going to die on them.”


DOCTOR’S ORDERS What everyone should know about ovarian cancer
Risk Factors

> Uninterrupted Ovulation
Women who have never delivered a child, had their children after age thirty, have never breastfed, or never taken hormonal contraception

> Obesity

> Endometriosis
Though it is still unlikely that patients with endometriosis will develop it

> Family History
First- or second-degree relative such as mother, sister, aunt, grandmother

> Other Cancers
A personal history or strong family history of breast cancer increases the risk of ovarian cancer.Personal history of colon or endometrial (uterine) cancers also increases it.

> Personal Genetics
History of either BRCA1 or BRCA2 genes increases the risk, but only 15 percent of patients with ovarian cancer have the genetic mutation (though some genetic mutations have not yet been identified).


Risk Reduction

> Birth Control Pills
Taking them for at least five years in total decreases the risk by 30–50 percent.

> Breastfeeding and Pregnancy
The longer one breastfeeds, and the higher the number of full-term pregnancies a woman has, reduces risk.

> Removal, or ligating, of tubes


BY THE NIMBERS

1.3 Percentage of women who will develop ovarian cancer

60+ Average age of women who are diagnosed

2/3 Number of cases diagnosed at stage three or four. “Women will often recall up to eight months of vague but persistent symptoms.” It is crucial not to dismiss bloating, back pain, pelvic pain, increased urinating, pain with intercourse. Though common, when these persist more than one to two weeks, women should be evaluated by a doctor.