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Sunday, Feb. 24, 2008

THE SKY'S THE LIMIT

SURGEON

Cancer specialist beats the odds


Staff writer

For breast surgeon Takako Kamio, 53, science is all about going to your limit to seek the truth.

News photo
Cancer surgeon Takako Kamio at work TOMOKO OTAKE PHOTO

Kamio is one of very few female breast surgeons in Japan — and one of the most sought-after. Patients wait for hours to see her at the hospital affiliated with Tokyo Women's Medical University, where she is an associate professor in a surgery department.

Kamio, who grew up near the Kushiro Marshes National Park in Hokkaido, spent a lot of time in her youth bird-watching there and collecting wild plant samples. So for her, she says, choosing "life science" as her career was a natural thing to do.

But she says she did not decide to specialize in breast surgery because she was a woman. Rather, she says, it was pure academic and professional curiosity that propelled her into that field.

"Being a breast surgeon means you also need to know a lot about hormones, radiology and anticancer drugs," the soft-spoken doctor said one recent night in a quiet and empty corner of the hospital's outpatient center, which is constantly thronged with patients and hospital staff during the day. "It's about the entire body. That's why I found this field fascinating."

Female doctors, no matter how aspiring and talented they are, have difficulty pursuing their careers because of the notoriously harsh working conditions in their profession. On top of tackling an unending daily stream of patients, they must also write papers, attend academic conferences and coach younger doctors, says Kamio, who is single and puts in long hours at work, barely making the last train every day.

This, coupled with Japan's rigid gender roles, which dump most household duties on women, has meant female doctors often cannot keep their jobs if they have children or their spouses are transferred out of town.

The situation is slowly changing, though, as women today make up a third of newly-licensed doctors in Japan. Some university hospitals, including Kamio's, have recently opened on-site nurseries for their workers' children, and have started training female doctors who once left their jobs due to parenting or other reasons.

But being a female surgeon has its advantages, Kamio says, noting that many women say it feels more relaxing to have a female doctor treat them for the illness, which can severely affect a woman's self-image and sexuality.

In addition, Kamio says she can be a little more forthcoming in explaining the need for a mastectomy (complete breast removal) than her male colleagues.

Chemotherapy and radiology

In Japan, half the women undergoing breast-cancer surgery now opt to keep parts of their affected breasts, a decision aided by advances in postoperative chemotherapy and radiology which have made any residual cancer easier to control. But Kamio is skeptical of the trend, saying cancerous tissues often remain after conservation surgery — and pose a greater risk of cancer coming back.

Kamio explained that she has found some male surgeons are hesitant to recommend whole-breast removal — even if they are not sure a partial removal will eliminate all the cancerous tissue — because they are afraid a mastectomy would devastate the patient's feelings.

"As a woman, I think I understand the pain of removing breasts," she said. "As a woman, I can also say more candidly that it's more important to save a life than saving a breast."

This does not mean that Kamio favors an easy answer. She says that her team of doctors works hard on improving their diagnostic and surgical skills to their limit, meticulously examining patients' pre- and post-surgery data so that they can remove cancers with precision.

"In this profession, you never stop learning until you die," she said, before rushing out of the outpatient center and into the inpatient ward, where post-op patients were waiting to talk to her. "There is no absolute truth, but I would never stop pursuing my efforts to seek the absolute truth."



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