Dr. Shani Paluch-Shimon helps shape global standards for breast cancer treatments. She believes the individual is integral to decision-making and feels empowered every time she helps a patient navigate her personal cancer journey.
Dr. Paluch-Shimon was drawn to oncology because it provides her with the opportunity to have meaningful and ongoing connections with her patients. While she assumes that her mother’s death from breast cancer at age 58 might have had a subliminal impact on her decision to specialize in treating young women, escorting patients on their cancer journeys suits the outgoing, Australian-born physician and mother of three. Her expertise is unquestionable. In addition to her role as director of the Breast Oncology Program at the Hadassah Medical Organization, she is the first Israeli doctor to serve as editor for breast cancer guidelines for the Clinical Practice Committee of the European Society for Medical Oncology (ESMO), the most important cancer authority outside of the US. Millions of women have their cancer protocols determined by these guidelines.
One out of 40 Ashkenazi Jewish women, in contrast to one in 250 to 300 women in the general population, are carriers of BRCA1 or BRCA2 mutations related to breast and ovarian cancer, as well as other cancers. Dr. Paluch-Shimon provides the specialized guidance to test for mutations and to decide on treatment for women who have them and to guide the women on risk-reducing measures. “I need to know my patients well to discuss decision options. A woman post-childbearing may make different choices than a young single woman.” She recommends that all Ashkenazi Jews consider BRCA testing and that all women with a family history of breast, ovarian or pancreatic cancer or a personal history of breast cancer seek genetic counseling to evaluate if they need testing, irrespective of ethnic background. If found positive, patients need to be in special screening programs that include breast MRIs. They also need to consider such risk-reducing measures as removal of the ovaries to reduce the risk of ovarian cancer.
Another area of interest for Dr. Paluch-Shimon is breast cancer in young women, who make up 6 to 7 percent of all new annual breast cancer diagnoses. Because she recognizes that young women with breast cancer have special needs, Dr. Paluch-Shimon has instituted a patient navigator system to help the young women through the maze of breast cancer tests, appointments and treatments. Hadassah is a pioneer in including a dedicated psychologist as part of the treatment. “Issues of body image, sexuality and fertility used to be considered peripheral, but they aren’t. We are dedicated to ensuring the best quality of life." To preserve fertility we can freeze eggs, embryos or even fragments of ovarian tissue that can produce new ova when treatment is done.”