Cancer victim takes business approach to tackle disease

It's a diagnosis that more than 288,000 women in the United States will receive from their doctor this year. Karin Firmani received hers more than six years ago.

Firmani, the former owner of Design One in Las Vegas, was diagnosed with breast cancer in April 2005. About two months later, Firmani had a double mastectomy. From there she went through months of chemotherapy.

After her radiation treatments ended in May 2006, she was declared cancer-free, and has been so ever since.

But with the rest of her life in front of her, Firmani knew she wanted to continue to run her own business. Today, she owns 10 New York-style pizza restaurants in China and is looking forward to other business opportunities.

"If you are lucky enough not to lose your life, start rebuilding immediately," she said.

Firmani, 54, began her business career in the mid-1990s with Design One, a sign and banner company that did work for casinos and other businesses in Las Vegas.

That business grew to include working on VIP events and producing logo merchandise and printed materials for the World Poker Tour and PartyPoker.com.

Firmani said it was exciting working with Mike Sexton, a 1989 World Series of Poker bracelet winner, and the poker tour.

"It changed my life at the time," she said.

While she was busy marketing poker, she noticed a lump, but chalked it up to stress.

"I thought I had breast cancer for at least a year," she said. "I had a lump that didn't go away. But my life was work, plus I felt great during the year."

And like most small-business owners, even with health insurance, she was concerned about the cost.

"It's going to cost me a lot of money. That's all I thought about," she said. "I wanted to be financially secure with whatever happened."

PAYING FOR CARE

Financially secure or not, Firmani found herself in her doctor's office a day before she was to take a business trip. She had decided to confront her fears after she was unable to drive home without pulling over and resting.

During her exam, she told her doctor about the lump under her left breast. The next thing she knew, she was headed for a mammogram.

"When he asked me why I didn't tell him, all I could say was I was too busy," she said. "It took about a minute for him to read the mammogram, before telling me I couldn't leave his office. I knew then I had breast cancer."

In addition to concerns about her personal life, Firmani also worried that her business would suffer.

"On Monday you realize that you're in big trouble and on Friday you are undergoing a biopsy," she said. "You realize everything you have, you have a big chance of losing it."

But first, she had to leave town for work on a weeklong World Poker Tour cruise. When she got back, Firmani flew to Baltimore for a second opinion at Johns Hopkins.

The cancer had spread to her lymph nodes and to one of her ovaries. If chemotherapy and radiation failed, she would have a year to live.

"I decided to have my surgery at Johns Hopkins," she said. "You have to understand, I thought 'As long as I can keep working and pay for all of this. I can do this.' "

THE BUSINESS APPROACH

Firmani said she approached treatment as if she were running a business, including analyzing the profit and loss of her care and making sure she could keep appointments with her clients.

She admitted that she might have lost some business while recovering for several weeks in Baltimore. The trick, she said, was staying in touch with her clients by email and phone.

Janis Stevenson, a business development adviser with the Nevada Small Business Development Center in Las Vegas, said that kind of planning is critical for small-business owners. She said business owners must weigh whether they have the mental and physical stamina to operate their business during a major illness.

"If your business is totally reliant on you, you have to figure out to what extent can you replicate yourself if you were to become ill," Stevenson said. "If not, (find) a person that you can refer your customers to on a temporary basis."

She said succession planning was a critical part of any business plan. Stevenson said she tells her clients that they need to look out beyond the start of their business.

COMMON BUT CURABLE

Breast cancer is the most common cancer among American women, except for skin cancers. The chance of developing invasive breast cancer in a woman's life is 1 in 8, or about 12 percent, according to the American Cancer Society. About 39,520 women in the United States are expected to die from breast cancer this year.

Dr. Susan VanBeuge, an assistant professor at the School of Nursing at the University of Nevada, Las Vegas, wasn't surprised by Firmani's reaction to her diagnosis and treatment.

"People who are successful running their own business have a different mindset," VanBeuge said. "They tend to want to manage their treatment like it's their business."

Firmani's decision on how to manage her treatment was her choice. What was out of her control was how her colleagues and clients would react to the physical changes -- including the loss of her breasts and dramatic weight loss.

"You start thinking they are going to say. 'You're not useful for us anymore,' " she said.

Firmani said she was worried about how her surgery and treatment would affect her appearance.

"Look, it's the town we live in," she said. "My appearance detracted from the very thing I do, which is market myself to other people."

Firmani said she didn't mind her physical appearance changing from her chemotherapy and radiation treatments, but she noticed those around her were "very uncomfortable."

VanBeuge agreed, saying that with some cancers, people may not notice someone is sick.

"But with breast cancer you can't hide it," she said. "Often (patients) are treated with steroids that will have an effect and during chemotherapy, you may look different."

The good news is that those who do regular self-examinations and yearly mammograms usually survive the disease. There is a 100 percent five-year survival rate for those who are diagnosed and treated during the earliest stages of breast cancer, according to The Breast Cancer Society Inc.

Firmani said she really doesn't like to give other people advice, but she makes one exception: don't wait as long as she did to visit a doctor after finding a lump.

Contact reporter Chris Sieroty at csieroty@reviewjournal.com or 702-477-3893.