Physician refuses to worry about her own breast cancer

Talking with Maria Sepe, MD, the day after surgery for advanced breast cancer is like meeting a tennis player who just won the championship. She’s bright-eyed and excited, eager to share her victory with anyone who listens, keen on sharing her blue ribbons and gold cups with any novice.

Sepe (pronounced sep-ee), 40, practices family medicine on Long Island. In 1997, she says, “Out of nowhere, this perfectly fine, healthy 35-year-old person, me, finds this lump. I saw this thing on my breast one day. I was getting dressed, and there it was, The day before, there it was not. Because I’m a doctor, I knew it was cancer. I also knew I didn’t want to die. We staged the cancer [tested to see how aggressive, or advanced, it was] immediately. It was Stage 4 with metastases to the liver – and me with no prior anything.

“I have an eight-year-old son who just had his First Communion. He’s smart. I’m divorced. He’s my life.” So she fights to live that life.

Sepe stays as positive as the Washington Senators singing “Ya Gotta Have Heart” in Damn Yankees. “I was chosen to do something,” she says, meaning she was chosen to have metastatic cancer. “I don’t know why it was me, but it was. I am a strong person. I am a very religious person. I’m Catholic, but it doesn’t matter, that’s just my brand.”

The physician/patient felt fine for several months. Then suddenly the cancer deteriorated fast, bringing anemia and dizziness. She’s whispering now, because her mother, who doesn’t know how sick her daughter was, is in the room. “Anyone could see that I was sleeping 24 hours a day and not eating. I was dying.”

She wanted to start taking Herceptin, but at that time it was prescribed only for compassionate use, “Which means it was not approved and not believed in, but you could get it if all the other medications failed and you won the lottery. Yes, there was a monthly lottery: If they approved you, you applied once a month to be allowed to take Herceptin. I was at death’s door and didn’t know if I would make it to the next month.”

Happily, Sepe won the lottery and started a course of IV Herceptin – plus a selection of alternative-medical treatments – and the combination “basically put the cancer away for a long time.”

For a year and a half, to be precise, when a CAT scan of her abdomen and pelvis showed two new lesions. “My oncologist made light of it, saying how small they were, only two centimeters, but I’m thinking, ‘They’ll grow and I’ll be dead.’”

Eventually the Herceptin stopped helping Sepe, and in November 1999, her oncologist recommended Xeloda, an oral chemotherapeutic agent produced by Roche Laboratories. It’s a treatment that helps many women for three to six months before failing, but in her case, it’s been a gift that keeps on giving. “It’s wonderful,” she says of the drug. “It’s phenomenal. Taking Xeloda is like taking vitamins. It’s nothing.”

As a physician and a single mom, Sepe has as busy a life as many women today. And, like many survivors, she has chosen to live every day to its fullest, plugging away as much as is comfortable. Prior to Xeloda, she didn’t take time off from work, but with Xeloda, free of IV poles and hours-long drips, she had the ability to accomplish even more: She quit working for other physicians and was able to set up her own independent practice.

Sepe thinks her cancer makes it easier to deal with cancer patients, as well as with friends, neighbors and sisters-in-law of butchers and bakers. “I always say, ‘I know exactly what you’re going through, because I went through it. You can beat this.’”

She talks as fast as an auctioneer, with a smile in every word. “I’m in recovery,” she insists. “I want to have bigger family. I do not intend for my son to grow up a single child.” Despite setbacks, despite additional surgeries (four in one recent five-week period), Maria Sepe remains optimistic. How? For starters, she says, “I have an unbelievable oncologist; there’s nobody like him on this planet. And the priests at church are so great, and I have the faith thing.

“Every freaking time something happens, it’s nothing. I won’t worry. I refuse to worry.”

Appeared in the newsletter of Living Beyond Breast Cancer.