In the final act of her life, Shannen Doherty recorded a podcast from her home, during which she opened up about her legendary TV career, her feuds with former co-stars and the unraveling of her third marriage to Kurt Iswarienko last year after she said she learned he had been unfaithful.
But Doherty’s greatest legacy as a famous person may have been her willingness to talk candidly and frankly about what it was like to live with cancer. The “Beverly Hills, 90210” and “Charmed” star died Saturday at age 53, nearly 10 years after she was first diagnosed with breast cancer in 2015. She released her most recent episode of her “Let’s Be Clear,” several days before her death.
In early January, Doherty brought her oncologist, Dr. Lawrence Piro, onto her show to have a conversation that they both probably hoped would be useful for anyone undergoing treatment for cancer. Their chat focused on the importance of the doctor-patient relationship, the rights of patients to change doctors and communication strategies that can help family and friends offer effective support.
When it comes to the doctor-patient relationship, Piro said they every patient needs to believe “you’re going to do everything for them, that you’re going to think about their case thoughtfully and, importantly, individually.”
Piro wasn’t Doherty’s first oncologist, she revealed. Following her 2015 diagnosis, she said she had been seeing another doctor, but had started to feel that the treatment had not been “very successful” and that “nothing was really changing.”
“I still had a tumor in my breast,” Doherty said. “I still wasn’t getting surgery. I kind of was feeling a little bit lost. The drug that this particular in college just had me on put me in a menopause. I wasn’t properly warned about that. I was definitely feeling adrift, if you will.”
Doherty’s cancer journey eventually included a mastectomy in 2016. She went into remission in 2017, but the cancer returned in 2019. In 2020, Doherty announced she had metastatic stage 4 cancer in 2020. In 2023, she shared that cancer had spread to her brain and bones.
It’s not clear from the podcast when Doherty starting seeing Piro, a top cancer researcher and the president and CEO of the Angeles Clinic and Research Institute, which is affiliated with Cedars Sinai Medical Center. The Hollywood Reporter also named Piro one of Los Angeles’ top cancer/oncology doctors.
Doherty said her decision to switch doctors came after an agonizing period during which she had to overcome the feeling that she said a lot of cancer patients have — that they somehow “don’t have the right to ask for a better doctor or to change doctors.”
Doherty and Piro revealed that they met through mutual friends, who introduced them at a dinner party. They jokingly said their first meeting was almost “like a blind date.” But Piro said, in a sense, they had to size each other up and decide whether they could work together, explaining that he sees the ideal doctor-patient relationship as a partnership.
For her part, Doherty appreciated that Piro wanted “shared decision-making,” while she would rely on his expertise and recommendations. She also felt it was important to let him know that she would take responsibility for her choices. “Part and parcel of shared decision making is accepting responsibility for the decision,” Doherty said.
This mode of operating as a doctor and patient meant that Doherty could set the terms in how she wanted to get news about test results and whether Piro thought the treatment was working — or not.
While Doherty praised Piro’s clinic for offering patients same-day results after an MRI or PET scan, she said she didn’t want to stick around to get the news in person.
“I chose to do it very differently from the beginning with you, where I said I don’t want to know my results in person,” Doherty explained. “Let me go home and call me with my results at whatever time works for you throughout the day, whenever you have a moment, whenever you have a break, whenever you know you’re not seeing a patient.
“I didn’t want to monitor my reaction for you, or for the nurse practitioner, or for anybody (who) was in the room with me,” Doherty continued. “I wanted to be alone so that I could have an authentic, like true reaction for myself and not try to put on a like game face for everyone. Because there’s nothing worse than getting bad news face to face, and you feel like you have to make the person giving you the bad news feel good. And I’m that person.”
Piro said Doherty was probably the only patient in his career who ever wanted to hear news delivered that way, but he said it “totally makes sense.” He thinks he might be “the same way.” “When I hear something, whatever it is, I want to process it personally to figure out how I feel about it before I want to tell somebody else,” he said.
During the podcast episode, Doherty also shared her frustration with people who felt it was OK to give her unsolicited medical advice or opinions, based on knowing someone with cancer or worse: having read something on the internet.
“I think it’s very dangerous for other people to have the conversation about your cancer besides your doctor,” Doherty said.
Piro agreed, saying that he always tells patients, after they received their diagnosis, to let their concerned, well-meaning friends know that they would like to take the lead on if and how they will talk about their cancer. He also advises loved ones to not “put your own stuff into” in any conversation. Most of all, Piro said it’s important for the patient’s quality of life that they not become “the cancer person.”
“And then you start feeling sick,” Doherty said. “I don’t have many people that I talk to cancer about. Like for me, I talk to you about cancer because I think you’re qualified to talk to me about cancer.” Six months before her death, Doherty also said she wanted people to know, “I have cancer, and I’m managing it. But don’t want it to define my everyday life.”
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