Breast cancer patient channels her love of teaching into improving care for future generations

American poet Mark Van Doren once said, “The art of teaching is the art of assisting discovery.” Debbie Oakley has been practicing this art for over 30 years.

She’s been a parent classroom volunteer, a classroom teacher, an assistant principal, a principal and the director of special programs, all in Spokane Public Schools. Now, she’s “assisting discovery” in a new way: participating in oncology research at the MultiCare Institute for Research & Innovation — the largest community-based nonacademic research center in the Pacific Northwest.

After being diagnosed with breast cancer, Oakley opted to join a study that examines the gut microbiome — the collection of tiny organisms, such as bacteria and fungi, that live in our gastrointestinal (GI) tract. These microbes are vital to the healthy functioning of our bodies, supporting digestion and our response to infection, among many other processes. The study aims to find out how these naturally occurring microbes affect the delivery of cancer therapy.

“After I read all the paperwork for the study, there was no doubt that I would sign up,” Oakley says. “It was something I could easily fulfill, and I could stop at any point if I needed to — there was no risk. Plus, there was huge potential that my participation could help someone down the road someday with my same condition. I thought to myself, ‘Wow, why aren’t more people doing this?’’’

An unexpected diagnosis, a meaningful opportunity

Oakley noticed the lump in her breast in March 2022. Just three months prior, she’d had a clear mammogram, so the lump came as a shock. After getting an ultrasound and biopsy at MultiCare Rockwood Clinic Breast Health, she received a diagnosis of triple-negative breast cancer, a rare type of cancer that tends to grow quickly and can be difficult to treat.

“My radiologist at MultiCare was so caring and sweet when he called to tell me the news, and it was still one of the hardest calls I’ve ever had,” Oakley says. “My husband passed almost six years ago, and I think the hardest part was not having that significant other by my side offering support. I had to do some self-talk to figure out how I was going to get through this.”

To navigate the uncertainty that comes with a cancer diagnosis, Oakley has leaned on the support of her family and friends, and she has also leaned into research. Her motivation for participating in a study, in part, comes from her lifelong passion for education.

“Whenever a doctor says, ‘I’ve got an intern here, do you mind if they are in the room?’ My answer is always ‘Absolutely, come on in!’” Oakley says. “The best way to learn is to be in the middle of it, whether that’s a classroom or an exam room. Participating in a study is just another way I can support learning.”

Another source of inspiration for Oakley is her late husband, John. A fellow educator, as well as a physical education teacher, runner and bodybuilder, he was diagnosed with amyotrophic lateral sclerosis (ALS), a progressive neurological disorder, at the age of 57.

“At the time, we looked into participating in an ALS clinical trial,” Oakley says. “John knew his diagnosis was fatal, but if participating in a study meant that he could help somebody else with ALS in the future, then he wanted to do that. Unfortunately, John’s age disqualified him from the trial. But I don’t face that barrier, so I want to do what I can to improve the treatment of my disease. I know John would support me in that goal.”

Mapping the gut microbiome

Part of MultiCare’s approach to delivering personalized, comprehensive cancer care is screening every patient with a cancer diagnosis for clinical trials or other studies that may be a good fit for their situation.

In Oakley’s case, her oncologist recommended the gut microbiome study, which seeks to better understand the relationship between gut microbes and a type of immunotherapy known as immune checkpoint inhibitors. Immunotherapy, a key part of Oakley’s treatment plan, harnesses the power of the immune system to find and destroy cancer cells.

“Recent studies have shown that the gut microbiome — all the different organisms that inhabit our GI tract — play a role in how the body responds to immunotherapies like immune checkpoint inhibitors,” says Jalene Tangen, clinical research coordinator at the Research Institute. “In this study we want to clarify that role — we want to know exactly which microbes influence cancer therapy.”

The largest nationwide microbiome study on cancer, this study could yield information that improves the delivery of care and the prognosis for patients with triple-negative breast cancer as well as other cancers.

Oakley’s participation in the study has involved giving blood, taking stool (poop) samples at home and mailing them in, as well as completing dietary questionnaires. The study is observational, meaning it examines the health outcomes of a certain group of people — in this case patients with specific cancer diagnoses — without intentionally changing or intervening in their care.

“What’s really impressed me about this experience has been the level of communication,” Oakley says. “Jalene made sure I knew exactly what the expectations for the study were and that I had all the information I needed at every step. She even filled out a calendar of important dates for me. There have been very few surprises throughout this process. The educator in me has really appreciated that.”

Sparking hope in the midst of hardship

After going through 24 weeks of chemotherapy, the lump in Oakley’s breast has shrunk considerably. But it hasn’t been an easy road; she has dealt with hair loss, fatigue, loss of appetite and many other difficult symptoms that often accompany cancer treatment — and the journey isn’t over. Oakley will continue immunotherapy for approximately six more months, with surgery and radiation to follow.

Yet despite everything she’s gone through, Oakley’s bright outlook and dedication to “the art of discovery” shine through.

“Debbie has looked beyond herself and focused on the bigger picture of what this study could accomplish, the lives it could change and the contribution to scientific advancement,” Tangen says. “And what’s even more incredible to me is that she does everything with a smile on her face. Despite being in the middle of treatment and not always feeling great, she keeps such a positive attitude that you can’t help but love to be around her.”

To learn more about leading-edge research and how you could move the science of medicine forward, visit the MultiCare Institute for Research & Innovation. You can also search the Research Institute’s current list of open clinical trials and studies.