Dr. Jerri Nielsen, 47, returned to the United States last week after the U.S. National Guard air-lifted her from the National Science Foundation’s Amundsen-Scott research station at the South Pole on October 16, 1999. Dr. Nielsen, who first detected a lump in her breast last June, had been corresponding via e-mail with medical oncologist Dr. Kathy Miller of Indiana University Cancer Center in Indianapolis. Last week, Dr. Nielsen traveled to Indianapolis for a follow-up on her condition and was admitted to the IU Hospital. A day before her release from the hospital last Wednesday, Dr. Nielsen issued a statement confirming that she has breast cancer.
In an interview with the Indianapolis Star, Dr. Miller said she believed Dr. Nielsen’s cancer probably originated in the breast milk ducts, where breast cancer most commonly originates. Dr. Miller was able to diagnose Dr. Nielsen’s condition from microscopic images of cancer cells sent electronically from her patient at the South Pole. Dr. Nielsen, who was air-dropped medical equipment and supplies in July, had performed several needle biopsies on herself using local anesthesia. After Dr. Miller made the breast cancer diagnosis in July, Dr. Nielsen began giving herself intravenous chemotherapy (injected through a vein) and hormone treatment (presumably tamoxifen) to shrink the tumor. Dr. Miller was able to supervise each chemotherapy session through video-conferencing equipment. Dr. Nielsen’s treatment was modified to reduce side effects and allow her to continue her function as the only medical doctor on the South Pole research station.
Dr. Miller admitted diagnosing Dr. Nielsen’s breast cancer from 11,600 miles away was extremely difficult. Her initial reaction was to order Dr. Nielsen’s evacuation from the South Pole last June and return her to the United States for diagnosis and treatment. However, Antarctica’s severe winter prevent planes from landing at the South Pole between March and October. During most of the winter, the average temperature is minus seventy-eight degrees Celsius (minus one hundred eight degrees Fahrenheit).
After learning she would not be able to leave the South Pole research station, Dr. Miller asked Dr. Nielsen’s colleagues if they believed Dr. Nielsen would be able to perform surgery on herself. (In 1961, a Soviet doctor in Antarctica removed his own appendix). Dr. Miller and other cancer experts then sent detailed instructions via email to help Dr. Nielsen and her colleagues diagnose and treat her condition, though extensive breast surgery such as lumpectomy or mastectomy would not be possible.
On June 22, Dr. Nielsen began performing breast biopsies on herself by inserting a needle into her breast and extracting fluid. The fluid was placed on a slide to dry, stained, and examined under a microscope to determine if cancer cells were present. Specimens were taken from a growth that appeared to be a cyst and from a larger breast lump.
Diagnosing breast cancer in a patient on the South Pole caused some technological difficulties, Dr. Miller told the Indianapolis Star. The station had a microscope but did not have the laboratory stains typically used to identify breast cancer cells. Pathologists had to come up with a procedure that would allow them to use a stain available at the station. Nielsen’s co-workers also modified a video camera to record microscopic images of breast cells that could be transmitted electronically to Dr. Miller in Indianapolis.
The first images Dr. Nielsen sent to Dr. Miller were too dark or blurry to examine, and some of the slides focused on the wrong area of breast tissue. Dr. Miller sent Dr. Nielsen’s co-workers images of what typical breast cancer cells look like, hoping to point them in the right direction. After about two weeks of taking images of Dr. Nielsen’s breast tissue sample, her co-workers were able to send Dr. Miller higher quality pictures. However, the stain used on the cells was too old to make a proper diagnosis.
On July 11, an emergency U.S. National Guard mission air-dropped medical equipment and supplies to help Dr. Nielsen and her colleagues to help diagnose and treat her condition. All of the supplies survived the drop except a Siemens ultrasound machine which broke on impact because its parachute did not deploy. Dr. Nielsen began hormone treatment the day after the supplies were dropped because of the minimal side effects involved. On July 21, Nielsen performed another breast biopsy on herself, and with the new stain sent in the air-drop, her co-workers were able to send a good set of cell images to Dr. Miller and cancer experts. It was clear at that point that the cells were cancerous.
Dr. Nielsen began chemotherapy on July 23 while Dr. Miller and her nurse, Dr. Haney, communicated with their patient through video-conferencing equipment that linked the South Pole station to the Indiana University Cancer Center. Several anti-cancer drugs in separate bags of saline solution were injected intravenously into Dr. Nielsen one at a time at specific rates. Dr. Miller scheduled chemotherapy sessions for Dr. Nielsen three Fridays in a row followed by one Friday off until Dr. Nielsen could be evacuated from the South Pole.
The breast cancer diagnosis and initial treatment was a frustrating, emotional ordeal for both doctor and patient. Dr. Miller said that she received e-mail correspondences from Dr. Nielsen almost every day. Though a medical doctor, Dr. Nielsen was trained in emergency medicine. She knew little about the specifics of diagnosing and treating breast cancer. Dr. Miller describes her patient’s e-mails from the South Pole as emotional and humble.
After an emergency U.S. National Guard rescue mission was delayed by severe weather conditions, Dr. Nielsen was flown out of Antarctica to New Zealand and eventually back to the United States earlier this month. Click here to view a map showing Dr. Nielsen's journey from Antarctica to Indianapolis (The freely available Adobe Acrobat reader is required to view this page)
Last week, Dr. Nielsen headed to Indianapolis for an evaluation at the Indiana University Cancer Center, part of the Indiana University School of Medicine. Dr. Nielsen was admitted to the Indiana University hospital and released a statement through the National Science Foundation confirming that she has breast cancer. She thanked everyone for supporting her through this time of crisis and expressed her desire to keep further information about her medical condition private. She was released from IU hospital last Wednesday and is now resting and receiving treatment back home in Ohio.
Dr. Nielsen underwent an extensive physical examination and mammogram last December 1998 before leaving for the South Pole. Though no abnormality was detected on that mammogram, Dr. Nielsen has had a history of benign breast cysts. She initially believed the lump she found during breast self-examination (BSE) last June was also probably benign until the lump became larger and firmer.
- For more information about Dr. Nielsen’s ordeal please visit http://www.imaginis.com/breasthealth/news/news10.18.99.asp, http://www.imaginis.com/breasthealth/news/news10.13.99b.asp, and http://www.imaginis.com/breasthealth/news/news10.6.99.asp.
- This article references the October 21, 1999 Indianapolis Star news article, "Her Lifeline to Hope: When a doctor at the South Pole found a lump in her breast, she got help from an IU cancer specialist" available at http://www.starnews.com/news/citystate/99/oct/1021st_nielsen.asp.
- The October 20, 1999 Associated Press report, "Doctor Rescued From South Pole Confirms Cancer Diagnosis" is available at http://www.ap.org/.
