After a breast cancer diagnosis, a SIUH director works to support patients in the midst of her own treatment journey

BY ERIK SCHONING • PHOTOS BY AMESSE PHOTOGRAPHY

For Rachel Smith, the past year has been the challenge of a lifetime. In July of 2025, the SIUH Director of Clinical Operations for Palliative Care was diagnosed with breast cancer. In the time since, she’s undergone a taxing treatment journey, become an advocate in her community, and leaned on the very same support systems she helped build at Staten Island University Hospital and Northwell.

In July of 2025, Smith was in one of the busiest seasons of her professional life, working to obtain certification for the SIUH palliative care program, while simultaneously building out SIUH’s supportive oncology program. (Palliative care, while often thought of as end-of-life treatment, refers to any quality of life care for patients dealing with serious illness, in this case, cancer.)

In the midst of everything, a subtle change in her breast would lead to a life-altering diagnosis: stage three invasive lobular carcinoma, the second most common type of breast cancer, and in Smith’s case, completely undetected in mammograms.

“I was blindsided,” Smith said. “It never even crossed my mind that this subtle change, my breast getting a tiny bit smaller, would mean cancer. As women, we’re in a whirlwind of life at this stage: working, kids, a husband. I didn’t catch it early. As scared as I was, it was helpful at the time to talk about it and share with other women.”

Following her diagnosis, Smith’s life was turned on its head. She turned to the SIUH health system and the people within it. Her first call after her diagnosis was to longtime friend and coworker Laura Longo, Assistant Vice President at Northwell Health, who helped her make initial appointments at Florina Cancer Center, Verrazzano Radiology and other providers. Smith lives with her husband and children in New Jersey, but there was never a question that she would be commuting to SIUH for her treatment; it was her home, where she wanted to be.

Smith quickly became an outspoken advocate in her community, speaking up at SIUH team member forums and encouraging friends and family to screen more diligently. (She cites at least two friends who, at her urging, were able to detect cancer early.) But as the year wore on, and Smith underwent a double mastectomy and hysterectomy on top of radiation treatments, she found the mental toll of treatment to be almost as staggering as the physical.

“I was so vocal throughout the beginning stages,” Smith said. “It was helpful for me at the time to talk about it, to remind people that screening saves lives. But then I got to a point that I needed a bit of space. I thought, I can’t be the mascot for breast cancer forever. I’m in a healthy space to speak up again now, but I’m always processing it.”

Fighting cancer takes real strength. Many patients struggle with anxiety, fatigue, pain and nutritional challenges throughout treatment, which can compound an already trying process. Oncologists themselves have limited time to focus on care outside of specific treatment. This is where palliative care and supportive oncology comes in: dedicated physicians on-hand who can help lighten what’s called the “symptom burden.” In the midst of her fight, Smith found herself turning to the very same supportive oncology program she had helped launch at SIUH, designed to holistically support patients as they undergo treatment.

For Smith, supportive oncology was a godsend, helping her navigate the trauma of her surgeries, as well as symptoms of early menopause brought on by her treatment.

“It was kind of full circle at that point, because I was struggling and that piece of [my treatment] was not being addressed,” Smith said. “Supportive oncology was one of the most important pieces of my journey, because it addressed the big picture: the symptoms, all the things that come with being diagnosed and living with cancer.”

In April of this year, Smith took on the new title of Senior Director of Operations at SIUH. Her treatment journey is still ongoing, as she remains under clinical surveillance and continues to deal with the uncertainty and exhaustion that many patients face as their fight drags on. As both patient and provider, as mother and wife, she has to balance caring for others, while getting the care that she needs.

“I’ll have my badge on and be on my laptop, and I’m sitting there doing blood work alongside the patients we develop these programs for,” Smith said. “It’s very surreal. I had a patient once that was like, ‘you don’t see that every day.’”

Even while prioritizing her own well-being and care, Smith has found real strength in helping others. She’s in a unique position, helping patients navigate a system she understands inside and out. She knows firsthand how transformative good care can be. Now, in the larger scope of her new role, she is unrelenting in her fight to deliver that care to others. That is who she wants to be: not an inspiration, but an advocate.

“Some people would say it’s crazy to take on more work. But if I didn’t do this, which is what I wanted anyway, I would have let the cancer win,” Smith said. “I still have more work to do, helping others and making an impact. I’m excited to be in this opportunity because it reminds me I’m alive.”

Florina Cancer Center — 475 Seaview Avenue / siuh.northwell.edu/cancer-institute