TORONTO - As a surgical specialist treating animals with cancer, Dr. Sarah Boston found herself in the role of both doctor and patient after discovering a suspicious lump in her neck.
The veterinary surgical oncologist had treated more than 100 dogs with thyroid cancer, and was concerned about the mass she found in her right thyroid gland. Too anxious to wait for her ultrasound appointment, Boston begged her husband — who is a large animal veterinarian — to bring his portable machine home, and she sat in their darkened kitchen to conduct her own self-exam.
The story of the unconventional ultrasound is one of many anecdotes which colour Boston's heartwarming and humorous memoir "Lucky Dog: How Being a Veterinarian Saved My Life" (House of Anansi Press), where she writes with poignancy and levity about her diagnosis and treatment for thyroid cancer. The Calgary-born animal doctor also shares the heart-tugging stories of owners who sought her out to care for their ailing pets.
Besides the commonality of cancer, Boston felt there was another key connection between her story and those of her four-legged patients: the need for both people and pets to have someone to champion their cause.
"There is an inherent need to be an advocate for your pet because they can't speak for themselves, so you have to take on that role for them if you're a pet owner. But I think it also is important if you're a patient that you either advocate for yourself or you have someone — either a family member or a friend — who can do that for you," Boston said during a book tour stop in Toronto.
Boston said it's also critical for human patients not to be complacent and that even if they personally aren't equipped with the medical knowledge, it's important to have someone to help them navigate through the process.
She recalled how others kept telling her the lump was likely benign or that she probably had thyroiditis (inflammation of the thyroid gland). She thought otherwise — and was proven right.
"There was definitely something in me that felt strongly that I couldn't wait, and I needed to push strongly for a diagnosis. But I also think that's because of my background," said Boston, president of the Veterinary Society of Surgical Oncology.
"I think it's important if your gut is telling you something's wrong, you need to keep pushing until you get a diagnosis."
It was roughly a nine-month stretch for Boston from the discovery of the mass in her neck through her entire course of treatment, which included two surgeries and radioactive iodine, which can be used to treat thyroid cancer. Throughout that time, she continued to work as a faculty surgical oncologist at the Ontario Veterinary College at the University of Guelph, taking breaks for treatment as needed.
Boston said she's been cancer-free for about 2 1/2 years, but there are still lasting effects.
"One thing that's just different after you have thyroid cancer, you don't have a thyroid gland anymore and you're relying on synthetic thyroid that you take," said the 41-year-old. "I'm used to having endless energy, and after going through this, I still have a lot of energy, but it's finite. ... By the end of the day, you do feel quite tired."
Boston said her experience also made her more empathetic to the pain experienced by her patients. In "Lucky Dog," she wrote of an ultrasound-guided biopsy where a sample was taken by aspiration, which involves placing suction on the biopsy needle with a syringe.
"I don't think I'm very brave, but it was really painful to go through that," Boston recalled. "Our dogs are such good patients so they'll let us do a lot, but I came back from that experience and said to my colleagues: 'We can't do aspirates on thyroids anymore on these dogs without sedation because they deserve that. ...'
"I think I've always been aware of pain management and good nursing care, but I think it does make you even more aware of that when you've gone through those things yourself," she added. "I really respect our patients because they really put up with a lot. They'll run out of a hospital after a thyroid surgery, and I was in bed for two weeks after my thyroid surgery. So, I think it gave me a real appreciation for my patients and how tough they are and how they're able to get through a lot — a lot of things better than we do."
Boston and her husband, Dr. Stephen Lee, relocated to the U.S. just under two years ago, where she is an associate professor of surgical oncology at the University of Florida.
Despite having lost patients and her own pets, animals remain a central part of Boston's life away from the job as well, with her cat Romeow and dog Rumble at home. She also recalled how her late dog, Molly, was a source of comfort as she underwent her cancer treatment.
"I've always had pets since I was a baby, so it would be very strange for me to live without having pets," she said.
"I enjoy it. It gives me comfort. ... It's almost like I can't imagine it any other way."