Why Does Kathy Miller Hate Pink?

Kathy Miller has never tied a pink ribbon in her daughter’s hair.

Pink ribbons make her mad, you see. It’s not that she doesn’t like the color pink, or ribbons for that matter.

But Miller, the Ballvé Lantero Professor of Oncology at Indiana University School of Medicine and the associate director of clinical research at the IU Simon Cancer Center, is one of the nation’s leading oncologists. As such, her main occupation in life is ending breast cancer. Pink ribbons remind her that she hasn’t yet worked her way out of a job.

“I can’t put a pink ribbon in her hair without thinking of the mothers I’ve taken care of who are no longer with us, mothers who can’t put pink ribbons in their daughters’ hair,” Miller said. “As her mother, that makes me mad.”

That anger aside, Miller sees hope. After more than 20 years of researching and treating breast cancer in the Vera Bradley Foundation Center for Breast Cancer Research, Miller knows how far breast cancer treatment has progressed. The advances coming in the next 20 years? Miller is busy imagining the possibilities. 

Small Town, Big Dreams

Miller was raised in Florida—Florida, Ohio. It’s a town of fewer than 300 people in the northwestern part of the state—the kind of place where everybody knows everybody.

From the time she was 5 years old, Miller knew she wanted to be a doctor. Through a child’s lens, Miller was fascinated by a doctor’s ability to restore a patient’s health. No one in her family had ever gone to college, but her parents encouraged her to follow her dreams.

They were so dedicated to this pledge they decided to have only two children to make college more affordable.  “I never felt pressure to go to college—it just always seemed like a given.”

Miller made good on the wishes of her parents. In 1981, she enrolled at the University of Miami. Her sister Michelle started college at the General Motors Institute before transferring to the University of California, Berkeley, graduating with an engineering degree. She’s now a principal at Hexagon Transportation in San Jose, California.

A biology major, Miller thrived at Miami. With a nudge from her advisor, she applied to medical school at the Johns Hopkins University School of Medicine. Her interview with Dr. James Jude, a Miami thoracic surgeon who is credited as being one of the three “fathers” of CPR, was so impressive he invited Miller to scrub in for surgery following the interview.

Finding Her Future

As a medical student at Johns Hopkins, she discovered just what kind of doctor she would be in her second year, listening to back-to-back talks on leukemia and lymphoma by pathologist Risa Mann.

“My ability to pay attention in lectures at that point topped out at about 45 minutes,” Miller said. “This one was twice as long, and I was completely captivated.”

Time in the lab of a pediatric oncologist Andrew Yeager investigating leukemia opened her eyes to the complexities and opportunities that existed for physician-scientists. “He showed me how the problems you see in patients can stimulate questions that can be investigated in the lab, and how insights in the lab can lead to clinical trials that can be tested in patients. There is an incredible synergy between those two that I just find so exciting.”

A Return to the Midwest

After medical school, her husband Jeff, with a PhD in education, accepted a position at the University of Illinois. Miller looked for a fellowship destination in the region and found IU School of Medicine.

George Sledge, MD, IU’s first breast oncologist and the physician who laid the foundation for the breast cancer program at Indiana University Melvin and Bren Simon Cancer, saw Miller’s brilliance on display early during her IU fellowship.

Her aptitude for both clinical work and research made her stand out among her peers, Sledge said. She co-published papers with colleagues and made a name for herself at the school. In 1997, she served as chief fellow during her training at IU.

“As much as just about anyone I know, Kathy is the complete package,” Sledge said of Miller. “Being equally competent at research and in the clinic is not something everyone is capable of. But Kathy thrives in both settings.”

Miller points to Sledge as a mentor, but he says that title is no longer fitting.

“I certainly was her mentor at one point, but Kathy has long since surpassed that,” said Sledge, now at Stanford University. “Now, of course, she is my colleague and my friend. Kathy is flat out brilliant.”

Supercharging Breast Cancer Research

After her fellowship, Miller and her husband moved to North Dakota, where Jeff had accepted a position. But Sledge was so keen to bring her back to IU, he made a trek out to plead his case.

“I flew up to Fargo—in theory to give a lecture at a local medical center. But mostly I was there to beg a lot,” Sledge said. “I have told people that it may be that my greatest contribution to the field of breast cancer was to haul Kathy Miller back from Fargo and get her working on clinical trials.”

Miller returned to IU School of Medicine in 1999. Quickly, her prowess as a physician-scientist helped solidify the school’s standing as a world leader in breast cancer research. Now directing clinical research at the Vera Bradley Foundation Center for Breast Cancer Research, Miller has also ascended to leadership roles within the university and on a national stage. She is writing and directing national clinical trials, serving on the National Cancer Institute’s Breast Cancer Steering Committee.

“If you live in a state like Indiana and you have a Kathy Miller that means—because of her exceptional talents as a clinical translational researcher—you are one of the first people in the country who has access to new potentially lifesaving drugs,” Sledge said. “You need talented researchers to move the field forward. Having a Kathy Miller supercharges a program and allows you to do lots of things you would otherwise not be able to do.”

These days, much of Miller’s clinical research is focused on improving outcomes for patients with triple-negative breast cancer, an aggressive type of breast cancer that lacks common traits used to diagnose and treat most other breast cancers. She’s attempting to identify new drug targets and combination therapies.

“Without clinical trials we would have no new cancer therapies. That means accepting that what we have right now to offer patients is the best we’ll ever have. And I can’t accept that,” Miller said. “There is an incredible excitement, as a researcher, to be the first one to see promising results, and to design a clinical experiment to test them. That part of this job never gets old for me.”  

Head for Science, Heart for Healing

One of the hardest parts of the job is having a difficult conversation with patients. When she was younger, Miller was convinced that if she could find just the right way to deliver the devastating news of a cancer diagnosis “nobody would get upset, nobody would cry, and it would all be OK.”

“That’s totally stupid,” Miller said.

Instead, she speaks to patients honestly and simply, with compassion and clarity. “And then shut up and let them have whatever reaction they need to have.”

Learning how to deliver difficult news is a key part of training for any young physician. It is why Miller always brings learners from her clinic with her for those conversations.

“It literally starts with where you position yourself in the clinic room. I want to be able to see the facial expressions of everybody else in the room. If the husband is sitting behind me, there’s information there that I’m not getting,” Miller said. “I explain to patients that I will do my best to answer all of their questions as honestly as I can. But sometimes the honest answer is, ‘I don’t know.’ And it’s sometimes because nobody knows.”

Linda Frische-Mouri had one of those conversations with Miller. Following her diagnosis of HER2-positive breast cancer in 2008, she was grasping for answers and reassurance when she met Miller.

Without clinical trials we would have no new cancer therapies. That means accepting that what we have right now to offer patients is the best we’ll ever have. And I can’t accept that.

“I remember saying, ‘Just tell me there’s hope,” said Frische-Mouri. “I knew I was in good hands with Dr. Miller. I felt I was in the care of a physician who was positive in her concern for my care and wellbeing, and someone who was very knowledgeable, encouraging and compassionate. For me, she was, and is, that voice of hope.”

Frische-Mouri, who elected to be part of a trial during her treatment, saw the two sides of Miller—teacher and researcher—shine through during her visits. As someone who craves information and knowledge, Miller’s willingness to answer all her questions was a constant source of comfort.

“She took the time to draw on a white board as she was explaining something to me,” said Frische-Mouri, who is now cancer free. “IU is lucky to have her because of the leadership she gives and the research she does in the effort to find new, effective treatments and cures for cancer.”

Living Her Dream—and More

Without a doubt, Miller said.