Doctor understands cancer survivors’ long-term care

Dr. Meagan Miller specializes in hematology and oncology. She also shares a personal interest in extended patient care.

By TJ Banes, IU Health Senior Journalist, tfender1@iuhealth.org

Cancer survivorship: It starts at the time of a cancer diagnosis and continues throughout treatment and beyond.

“Most people think it’s something that starts after you finish treatment,” said Dr. Meagan Miller, who started the adult survivorship clinic at IU Health Simon Cancer Center. The clinic focuses on patients who were younger than 40 when they were diagnosed.

What does that look like for a patient who learned of a cancer diagnosis in their teens or early 20s?

It means meeting them where they are in life. It means helping patients address different challenges they face after completing therapy. The focus is on prevention and reoccurrence, education and advocacy. The focus is on guiding the patient to screenings for early detection of new cancers. The focus is on connecting them with a community of supportive providers.

“Survivorship is such a new field. Many people don’t understand that a cancer diagnosis is something that comes with long-term side effects,” said Dr. Miller. She knows, because she has lived it. When she was 17, she was diagnosed with Ewing sarcoma, a rare, aggressive cancer that forms in the bone or soft tissue. She was a senior in high school, excited to begin applying to colleges, taking campus tours in-between rounds of chemotherapy.

“Most 17-year-olds aren’t facing their own mortality. I’m in the middle of class and need to throw up because I just finished chemo and other people are thinking about the fight they had with their boyfriend,” said Dr. Miller, 35.

While every person’s journey is unique, Dr. Miller comes from a starting point of understanding diagnosis and treatment. The physical scars often heal, but there are long-term side effects.

“When I went through it, I had no muscle mass, I lost a lot of weight, and the survivorship plan was ‘we’ll see you in a few weeks.’ There are things that wouldn’t go away and when I knew I wanted to be an oncologist, I wanted to work with survivors,” said Dr. Miller.

Some of those “things that wouldn’t go away” include neuropathy, pain, issues of fertility, overall physical and mental health. Miller estimates she works with more than 100 adolescents and young adults. She talks to them about their individualized risks as they get older. For instance, some chemotherapies can increase the risk of blood or bladder cancer or may have long-term effects on the heart.

“We look at 10-20 plus years down the line with the information we have available,” said Dr. Miller, who is originally from Kansas and attended Kansas University School of Medicine. In 2016 she moved to Indianapolis where she completed her residency in Internal Medicine and her fellowship in Hematology and Oncology at Indiana University. Her specialty is in thoracic oncology and in the areas of genitourinary and gynecology. In addition to seeing patients through the Survivorship Clinic she practices at IU Health West.

“Coming back to the hospital after a diagnosis and treatment can be triggering. I work to help reduce that stress,” said Dr. Miller. “Because I’m working with adolescents and young adults, a physician visit can interrupt a life they are building – careers, family. It can also cause financial hardships.”

She takes all of that into account. When possible, visits are conducted virtually. In person, she starts with a physical exam and also assesses the patient’s mental health.

“We talk about things to look out for. Do they need to see a genetic doctor? Is there an increased risk of something based on family history? We also talk about lifestyle such as preventative practices – wearing sunscreen, general screenings based on age, and their diet and exercise routines,” said Dr. Miller, who works with a team of clinicians with a vested interest in long-term care for patients diagnosed with cancer.

“Navigating the healthcare system can be overwhelming. I know how to help and where to refer them for that specialized care.”

Outside of work, Dr. Miller is married and enjoys traveling and trying new restaurants.