“I have a confession to make.
For many years, I thought ‘Breast Cancer Awareness Month’ to be… somewhat redundant. Is there anyone out there who doesn’t know breast cancer doesn’t exist? Do we need to tell more people about it every year? What about childhood cancer? What about all the other underfunded and under researched cancers that don’t get any national recognition whatsoever?
Almost 2 years ago, that opinion would be quickly and radically challenged.
Life was pretty normal in the days and weeks leading up to October 31, 2016. My mom was due for her annual mammogram, but her primary care doctor reassured her it wasn’t really necessary according to the new guidelines; she was a low risk patient, being that she was young and had no family history of breast cancer at all. She had already had many annual mammograms and all of them had been perfectly normal. ‘Technically’ the guidelines called for only biennial mammograms. But because her insurance still covers an annual mammogram, my mom thought, ‘I might as well…’
That split-second decision and that appointment Halloween day would soon change the course of our lives forever.
You see, that year’s mammogram was the very first one to be far from normal.
Late November: the biopsy
After a suspicious looking mammogram and a follow up to primary care, a biopsy was scheduled for the end of November. The biopsy later confirmed what no person wants to hear: cancer. Invasive Ductal Carcinoma.
December: initial consultations
Originally, the recommendations were all encouraging. At her first appointment with the surgeon, my mom was reassured that the tumor was small and there was no immediate rush to start treatment. He assured her this was common, that her case was nothing special, and was fairly certain she would be able to be ‘cured’ with just surgery and maybe some radiation treatments, too. With this information in hand, and knowing that my sister’s wedding was just 2 short months away, my mom opted to schedule her surgery for just after the new year, postponing treatment in order to be fully available to our family during the Christmas and wedding celebrations. She was able to celebrate Christmas at home with all 3 of her kids, 2 in-laws, and a beautiful grandbaby. Just 5 days later she was overjoyed as she watched my sister marry the man of her dreams.
January 9: surgery
Before we knew it, the joyous celebrations were over and it was time to tackle this beast head on. It was officially surgery day. Everything went as planned, thank God, and in just a few hours my mom was on her way home to rest and recover. Technically, on this day, the cancer was gone.
Late January: test results
After what felt like an excruciating wait, pathology reports were in and it was time to meet with Oncology. The margins were clear, and thankfully so were the lymph nodes. But this is what none of us expected – yes, this tumor was indeed small, but it was a beast. In fact, the tumor was characterized by pathology as a Grade 3 (high grade) – the most aggressive a breast tumor can get.
February: more tests; more waiting
Because of the grade 3 distinction, the oncology team was no longer convinced that radiation would be my mom’s only upcoming battle. The beginning of February was full of waiting and wondering as the tumor was sent off for additional testing. More information was needed to determine what the next few months would entail. Of utmost importance – HER2 testing and Oncotype DX – which would indicate her specific risk of recurrence (or the chance that her cancer would come back). This in turn would help my mom and her medical team determine if chemo was indicated. Because even though technically the cancer was removed and gone, she still had the next 40 years to plan for.
In general, an oncotype ‘score’ of anything less than 18 indicates low risk and means that chemo is not likely to be a helpful part of post-surgical treatment. A score between 19-30 is more of a ‘grey area’ – there’s no strong research to support that patients who fall in this area will reap noticeable differences in their prognosis with or without chemo. A score of 30 or higher means the risk of recurrence is HIGH, and the benefits from chemo are likely to outweigh the risks and side effects.
During this time, it felt like every day was 100 hours long – just waiting for the phone to ring and praying every day that the results would bear some good news. During this time, I prayed relentlessly for a low score. I begged God. I asked all of my friends to join me in boldly praying for a number lower than 10. I had never in my life wanted such a specific answer to prayer. Less than 10, please, just be less than 10.
In the meantime, my mom met with a radiation oncologist to discuss her options for radiation. There were 2 options presented: Traditional external beam radiation, which would last for 7 weeks, or Brachytherapy, in which radiactive pellets are sent directly to the cancerous site. While this requires 2 visits per day – radiation is complete after just 5 days. Thankfully, an ultrasound showed that my mom was in fact a candidate for brachytherapy. One piece of good news….
Finally, after many delays, the genomic testing was completed and the results were in.
GULP. Technically, we were within the ‘grey area’ but just barely….
I still remember the phone call from my parents. I remember the way my heart pounded and my mouth went dry. They didn’t even mention the number at first, just that there were no more decisions to be made. My mom’s mind was made up as she announced the bravest decision she’d hopefully ever have to make: Chemo was officially a go.
Late Feruary: radiation
Finally, towards the end of February, it was time for radiation to begin. Unfortunately, contrary to our initial hopes, it was no longer the only treatment that loomed ahead. Radiation came and went quickly with no complications (other than the fact I got in a serious car accident on my way to pick up my mom and take her to the cancer center. Seriously, God?!) My mom was required to be at the radiation clinic twice a day and live with a device implanted in her breast, which of course is no small feat, but at the end of the week, she was DONE. Radiation: CHECK.
On to chemo.
March – May : Chemo
First came an overwhelming meeting with a chemo educator and plotting out all that would be required over the next few months: pre-chemo laboratory tests to check blood counts, twice daily temperature checks to monitor for fevers, post-chemo Neulasta injections, multiple 5-day oral steroid courses, at home nausea medications (to be taken on a strict schedule), and of course the actual chemo infusions themselves. The packet of necessary precautions we were given felt thick enough to be its own dictionary. For starters: no fresh flowers. No fruits and vegetables. No contact whatsoever with sick people. No leaving the house at all during ‘low count’ days. Limited visitors at all times. No traveling. And the list goes on…
Required education: completed.
Daily checklist: made and color coordinated.
Chemo infusion appointments: scheduled.
It was time for the first round of chemo.
I have to say – I will always be incredibly proud and amazed at the way my mom marched into that cancer center on that day and voluntarily received her first dose of IV chemo. It wasn’t ‘required.’ The days leading up to this, she felt perfect. She had no symptoms. The surgery had indeed made her ‘cancer free.’ But chemo? It came with more side effects and scary realities than she probably even realized. She knew she was in for a rough couple of months. She knew how sick she might get, and how much of her freedom she was giving up. But I will always remember the words she said to me with tears in her eyes when I asked her if she was sure.
‘I plan to be there at your wedding, Sarah. I want to hold your babies. I want to play with my grandkids. I’m going to do this.’
All things considered, my mom’s journey through chemo was relatively uncomplicated. Aside from one terrible bout of chemo-induced colitis, a necessary change of chemo dosing, and a few fever scares leading to prolonged Emergency Room visits, chemo came and went without any major complications. Fatigue and hair loss were her most prominent side effects, and luckily the at-home nausea medications did their job.
Fast forward to October 2018: remission
It has been almost exactly 2 years to the day since my mom went in for that ‘optional’ mammogram. In those 2 years, in addition to everyday life, my mom has attended and enjoyed her daughter’s wedding. She has been there for 2 Christmas mornings. She has shared countless laughs with her granddaughter. She has supported a daughter through pregnancy and helped her navigate life with a newborn. She has supported me through a career change and helped me navigate my own chronic illness. She has been there for all of us, in ways I can’t even describe.
Looking at all of this in retrospect, it is so easy to see how drastically different this experience could have been. I get tears in my eyes every single time I think about what might have happened if my mom waited until the next October to go in for a mammogram; and because of this, I now know how important awareness is, and I am here today to shout from the rooftops that…
Early detection saves lives.
Even after the mammogram, knowing exactly where the tumor was, none of my mom’s doctors could feel it from the outside. It hadn’t grown large enough or spread far enough to cause any noticeable symptoms or pain. A self-exam would have never discovered the tumor until it was far larger. An abnormal mammogram reading was the one and ONLY thing that led to her early diagnosis and treatment – and, in my honest opinion, it is the one thing that saved her life.
Early detection saves lives.
‘Check your bumps for lumps.’ ‘Feel them on the first.’ Remind a friend to do the same. See your doctor regularly. Get an annual mammogram after age 40 – no matter how much you dread that appointment. I know my mom was reluctant to get that mammogram 2 Octobers ago. But I sure am glad she’s here to tell me about it.
I’d be lying if I said I’d completely left this ordeal behind us. I’d be lying if I said I wasn’t still scared. Because while her initial breast cancer is defeated, I’m haunted by the fact it is actually the recurrence of breast cancer which is responsible for most deaths from the disease. In the meantime, I thank God for every day that we get to enjoy together. I thank my mom for selflessly getting that mammogram; for choosing to battle through chemo so she could be there for us. I pray constantly that recurrence is not a part of our story. And I pray that somehow God can use our story to raise awareness for early detection, and ultimately to bring glory to His name.
Early detection saves lives.
‘Save the tatas’?… Sure. But more importantly, lets fight to save the mothers. The wives. The sisters, daughters, coworkers, friends, and strangers. Because for what felt like an eternity but was really only a brief time, I genuinely feared I would lose my mom to this terrible beast. And I hope someday no daughter ever has to know that feeling. Never. Again.”
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