Breast Cancer

Shortly after my cancer diagnosis, I began to receive good-hearted advice from my family and friends. They all wanted me to join a cancer support group. Why? Because my crew did not think they were able or qualified to support me like other cancer patients could.  After all, how many 32 year-olds do you know with Stage III breast cancer? 

For me, I knew it was critical to stay true to myself and that my strength came from the vibrant, colorful, energetic things and people in my life. So at each chemotherapy session, I would sit with friends, who traveled from as far as Amsterdam, and took time from their busy schedules, to join me at the NYU Cancer Institute for hours of infusion, cupcakes, funny stories, dirty jokes, dirtier magazines, champagne and lots of laughs. We would laugh so hard and so loud that one time I remember saying, “Guys, we have to be a little quieter…there are sick people here.” Honestly, it was only when they stopped laughing and looked at me that I realized that I was one of those sick people. 

 The guilt I felt watching their faces crumble as they hugged me – it was intense and sometimes more than I could handle. And in the sparse, quiet moments I secretly wondered if they all came to say their good-byes. I felt awful watching my friends and family stand witness as I fought the good fight. To me, I was taking them down a dark and irreversible road which would forever mark them and strip them of their innocence. The emotional weight of being a cancer patient can take you in so many directions…fear, sadness, anger, self-pity….mine was mostly guilt and well, maybe, some good ole-fashioned anger, peppered in for good measure.

 So how did I get here? After all, I was young (only 32), fit, strong, newly married, at the height of my career and planning to start a family.  The simple truth is that I took my dog, Bella, for a walk one beautiful summer day and came home with breast cancer. Yes, you read that right.

 I was walking my dog and the next thing I knew, I was flying through the air. Bella gave me one strong, sudden tug on my left arm that surprised me and jerked me forward and off the ground, dislodging an avocado-sized tumor from my armpit in the process. The tumor was a lymph node engorged with metastatic cancer. No lumps or bumps on the breast…only a tiny spec at the very base of the chest wall that silently and aggressively ravaged its way through my body. And that enormous lymph node had been working overtime, doing its damndest trying to prevent the cancer cells from spilling over into other organs. By luck, by miracle, that walk with Bella saved my life because, according to my doctors, we would have not been able to find this in time or in any other way. After all, I was too young to even go for a mammogram.

Being diagnosed with Stage III, Triple Negative Metastatic Breast Cancer, at my age and with no family history, the doctors kept saying it was a “remarkable” case. I’ve never wanted to be more unremarkable in my life. I was thrust into dose-dense chemotherapy a few days after diagnosis and told that the chemo would likely kill my chances of ever having children, could cause other cancers or even heart failure…but I did not have even one day to waste, let alone the two weeks I needed to preserve my fertility.  It was my only fighting chance at survival, or so they said. I was led to believe that there  were no other options for me so late in the game. So I quit my shiny new job, said a prayer that my fertility would remain in tact, and assumed my new role as CEO of Cancer Treatment. 

The ironic thing is…the cancer didn’t hurt. It was the treatments that I suffered from! And it was a grueling experience. Dose-dense chemo is not for the faint of heart. The chemical agents I received, also known as “Red Devil,” were the same used in the mustard gas for extermination in WWII. It can cause cardiotoxicity (heart failure) and should typically be administered once every 3-4 weeks. Mine was administered once every 2 weeks for maximum impact. So, in essence, what my doctors attempted to do was bring me to the brink of death without actually pushing me over that slippery edge. Giving me a little time to recover and then blasting me again. It was all grit and white knuckling mixed in with inappropriate jokes at even more inappropriate moments that carried me through those days.

During the four months of chemo, I also went through genetic testing and found out that I carried the BRCA 1 gene mutation, which all but promised a nearly 90% return of my particular cancer in my lifetime. Doing that genetic test changed the trajectory of my treatment. Very quickly, my medical team switched gears from previously discussing a minor lumpectomy to now recommending a double radical mastectomy where they would actually scrape down to the chest wall. And that is what I did, with great difficulty. Not because of vanity. But because I would forever have these scars, reminders of my fragility. Reminders that if it were not for modern medicine, that I did not qualify for Darwin’s survival of the fittest theory. I thought the scars would make me feel broken, amputated…frankenstein-ish. 

I finished chemotherapy on December 9, 2005 and on January 11, 2006 I closed my eyes and surrendered to the surgeons for the most aggressive mastectomy they had to offer. Six weeks of daily radiation, that tagged my left lung and heart, followed.

To my devastation, I was left in full-blown menopause from the treatment and really twisted up about it. In general, my outlook on my cancer was positive. I understood that although I got hit by the proverbial bus, that all my lucky stars had to align for my dog to find my cancer. I could deal with anything, but infertility? No! I did not sign up for that!  Knowing how much we wanted a child, my oncologist said that he would sign all the adoption papers we needed but that I had to wait at least three years to make sure that cancer did not return. So after much discussion and anguish, we decided that we had no choice other than to wait…but determined that we would become parents one day – regardless of how a child came to us.

Less than two years later and still struggling with infertility, I shockingly discovered that I was spontaneously pregnant…for the first time, and only time, in my life. My stunned and concerned oncologist told us that I was not far enough away from the cancer to even consider this pregnancy. He said that if we wanted to do the right thing for my health, we would terminate.

What? Terminate the pregnancy? Um no, I’m not the one. For me there was only one clear option! There was no way I would ever consider stripping myself of this unbelievable gift, this miracle, this baby that found its way into our life against incomprehensible odds. 

At the baby ultrasound, the technician found the baby’s heartbeat. Her words still dance in my mind, “There’s the heartbeat… and there’s the other one. You have two babies!” Twins! Time stopped and my life changed in an instant. It was the most defining moment of my life. Both girls’ names are inspired by my cancer journey.  They leap from on my tongue as reminders of both hope and gratitude.

And my skeptical oncologist? He said that I was the first patient in his entire career that was able to conceive a child, let alone two, after the kind of treatment I received. He came to my hospital room when the girls were born to hold them and see that life actually exists on the other side of cancer. I’m happy to report that there have been other pregnancies since mine at NYU!  What I’ve come to realize is that no matter how well-meaning they are, doctors simply cannot not know everything and cannot be expected to. 

The scars I thought would haunt me? They turned into the most beautiful reminders of my grit and good fortune. I feel like a Japanese vase that has been cracked but then quickly reassembled. The cracks, painted in gold, are meant to  tell a story of beauty and strength in the broken places. And that’s what I have become – strong in the broken places, in every way!  

I tell my story to say that miracles are possible, that you should trust your instincts, that you should question everything…and that you should never give up on hope or on yourself – ever!  We lost my Bella many years ago but every time I pass the spot where she pulled my arm that day, I look up into the sky to thank HER and the universe of endless possibilities. And when I look into the eyes of my daughters, I think of hope everlasting and the perseverance of the human spirit. Nothing is impossible.