My Sister has breast cancer too!

Just as I was thinking my life could not get any worse, my younger sister called and said that she had breast cancer too. When I was diagnosed I called my sister and told her that she should go get a mammogram. She did so immediately, and low and behold she had not one but two lumps in her left breast. She too had a biopsy and sure enough she had the same invasive, ductal carcinoma cancer in her left breast that I had. Hers was at an earlier stage in that it had not spread into her lymph nodes. My sister’s breast cancer differed from mine slightly in that it was positive for the dreaded HER-2 receptor. Both of our cancers were estrogen and progesterone positive (ER and PR positive). So at the ages of 33 and 31, respectively, we were both diagnosed with aggressive breast cancer. All I could think about was “How could this happen to us? Why, Why, Why?” Although I realized that my diagnosis had lead to an earlier diagnosis of my sister’s breast cancer and probably saved her life, I still felt somehow guilty and responsible for the pain that lay ahead for her. She was advised that she had no choice but to have a mastectomy of her left breast because she had two separate tumors in different quadrants of her breast, so after much thought and deliberation she elected to go ahead and do a double mastectomy to prevent any future breast cancer in the right breast. Luckily she would be one of the first to receive the new miracle drug, Herceptin, designed to directly target the HER-2 respecter in her cancer. She would also need to endure 2-3 months of grueling chemotherapy, followed like me with tamoxifen for at least 5 years. My sister having just been married for a couple months has no children. She, too, began to research the best options for her to preserve her fertility so that she could someday have children. Now that my sister had breast cancer, we had our own club of two. We had a built in support network. We began to consult each other almost daily on everything from our treatments to what type and color of wigs to buy, to the optimal time to shave your head to avoid the trauma of loosing it strand by strand.

Mobilizing for Battle:

After receiving my diagnosis, my body and mind seemed to mobilize for battle. My days became a world-wind of doctor appointments. The whole thing seemed to almost take on a life of its own. After receiving the biopsy results we quickly met with an oncologist from the recommended group to find out my destiny. We discussed whether I would need a mastectomy or whether I could get away with a lumpectomy (just removing the tumor and not my entire breast). After looking me over he thought I would do well with a lumpectomy. I was all for retaining as much of my body as possible. He confirmed that I would need to undergo 6-8 months of chemotherapy followed by 6-8 weeks of radiation treatment to the effected breast. In addition, I would need to take a drug called tamoxifen for 5 years that would fight the cancer causing agents in the estrogen that my body naturally produces. He called it hormone therapy. He promised that I would be able to continue to work full time throughout the chemotherapy which he would administer on Friday afternoons (every three weeks) along with a hefty dose of anti-nausea medicine, steroids and a whole host of other drugs to counter-act the side-effects of the chemotherapy. He said that he had a drug to counter-act every side effect of chemotherapy, except one. I would loose my hair, all of it, within 2 weeks of my first treatment. In addition, I would likely stop ovulating maybe permanently. Even if my cycle came back for a few years, it was certain I would go into early menopause probably before the age of 40. Worst of all, I could not try to get pregnant for at least 5 years after I finished all my treatements. My husband and I had always planned to have at least one more child and in fact had planned to try for a second this year, so this last piece of information was particularly devastating to me. All I could ask myself was how could this be? My mind went into overdrive. I knew that there had been advances in the last few years regarding fertility treatments for cancer patients. I just knew I had heard that someplace, so I immediately went to work to figure out what could be done to preserve my ability to have another child. Something inside me refused to take no for an answer. So I prepared for battle..... not just to save my life but to save the lives of my unborn children.

Realizing that I am indeed mortal:

So there I was 33 years old with breast cancer. I went through the gamete of emotions. My first order of business was to take a mental inventory of my life and decide if I was ready to die. Had I lived the kind of life that I was proud of? After much soul searching I decided that I had indeed had a great life. I decided that if I were to die of this disease, I could do it without regret….with one exception. I confessed tearfully to my husband that if I were to die now, my one regret would be not seeing my son grow into a man. Breast cancer unlike many other cancers has an incredibly high survival rate…upwards of 80% largely due to early detection. So what becomes critical is ones ability to live beyond the initial shock of realizing that yes “I am indeed mortal”. On a day to day basis most of us do not put much thought into our mortality. So to come face to face with your mortality in a split second and to face it again and again each day as you examine your bald head in the mirror is a big wake-up call. For me the best way to deal with this daily reality check is to constantly remind myself that everyone is mortal, not just me. The difference between me and everyone else (i.e. those not living with cancer), is that I am keenly aware of my mortality each and every moment of the day. I use this constant reminder of my morality to live each day to the fullest and end each day asking myself “If I were to die tomorrow would I have any regrets?”

My Breast Cancer Diagnosis:

I will never forget the day my doctor uttered those horrifying words “I am sorry to tell you, but that is a cancer tumor that you have in your left breast”. I was 33 years old. The date was August 4, 2005. In a split second my life changed forever. I did not cry, but strained instead to listen to my doctor in an attempt to comprehend the magnitude of the situation. Meanwhile all I could think about was that I was too young to die. My mind, body and soul seemed to scream the thought over and over again. Finally, after seeing portions of my life flash before my eyes…..my beautiful wedding to my husband on a hilltop overlooking the ocean in Fiji, the birth of my beautiful son one year prior…..I was finally able to regain enough focus to ask what stage of cancer I had. My doctor said it was too early to tell, but I would eventually learn that I had Stage II cancer because my cancer and spread from my left breast into the lymph nodes under my arm. My doctor offered a few other sage words of advice and then recommended a local oncologist group. One piece of advice that he gave me would continue to ring true during the course of my treatment. My doctor encouraged me to remain in Austin for my treatment. He informed me that the protocols and treatment for most breast cancer is standardized throughout the United Statues. Thus, there was no need for me to go running off to MD Anderson and put myself and my family through months of stressful travel to Houston, when the oncologists in Austin would utilize the same protocols as MD Anderson. Nothing against MD Anderson of course which is a wonderful cancer treatment facility which provides services to those with special types of breast cancer or unusual circumstances surrounding their breast cancer such as diagnosis while pregnant. I kept asking myself "How at the age of 33 did I come to have breast cancer?". I came from a healthy family with no history of cancer. I am very healthy (aside from the breast cancer). I exercise regularly, eat well, and have regular check-ups. In fact it was I who first found the lump and had the initiative to go see my gynecologist. I had breast fed my son for 8 months during which time it is impossible to identify any type of lump in the breast. I had thought at one point in time that I felt one, but it was just impossible to tell due to the constant growth and shrinking of milk ducts. It was not until after I stopped breast feeding and things shrank back to their normal size that I realized that I did have a good sized lump that just did not seem to be going away. So finally one day I called my gynecologist and went in for an appointment. He told me that it was probably just a clogged milk duct and nothing to worry about, but he wrote me a script for an ultrasound anyway. I let that lay around on the seat of my car for a couple weeks and then finally decided to take it seriously and called and made an appointment at a local women’s imaging center all the while thinking: “There is no way I have any type of cancer, I am too young and too healthy. What are the odds?” When I finally went for the ultrasound what the technician and I both saw on the screen was alarming. There was indeed a big black spot in the middle of my breast. They quickly whisked me off for a mammogram and indicated that they were going to recommend a biopsy. My gynecologist called me within minutes of receiving the results and told me to make an appointment with a surgeon for a surgical biopsy. His nurse said that if I could not get in with the doctor they recommended that I should immediately see anyone else in the practice that was available. I slowly began to become alarmed. What scarred me was the fact that each new person that looked at my mammogram seemed to become increasingly concerned for me. So that is how I came to find myself lying on a surgeon’s exam table as he performed a needle and core biopsy of a very large lump in my breast on my son’s 1st birthday and what should have been a day of joy and celebration.