A chance conversation with an insistent friend meant Cathy’s breast cancer was caught early, but that was just the beginning of a chain of unforeseen events.
I had raised two kids and worked in a man’s world for decades as a real estate attorney. Breast cancer wasn’t something I knew much about or even thought about. In fact, at the time, I was very focused on a big project. We were moving the family home from the suburbs of San Francisco up to a small town in the mountains. I was having a goodbye lunch with a friend when she asked if I was up to date on my mammograms. I assured her I would get to it after the move, but she was relentless. Do it now, do it before you move, do it while you have access to 3D mammograms. I didn’t feel the same urgency she did. She knew a number of friends who had been diagnosed recently and was very focused on it.
At her insistence, I called the Women’s Center to make an appointment and told them I needed it right away because I was moving. They accommodated my schedule and I went in two days before the move. At one point, they told me they needed additional images of one breast because they hadn’t gotten a clear picture. That was a little unusual, but I really didn’t give it much thought. I was focused on all I needed to do in the next couple of days. Getting a mammogram was just one more thing to check off the list.
A Moving Experience
The moving truck was already in the driveway two days later when they called and said I needed to come back for an ultrasound. I went right over, leaving the men and the boxes behind. The technician did the first part of the ultrasound, but then the radiologist came in and kept taking more and more images. She said there was a lump and that she wanted to do a biopsy. “It’s now or never,” I said, “I’m moving this afternoon.” So, with the help of an assistant, she did the biopsy right then. I was so preoccupied with the move that I really didn’t think about what it meant. I was just anxious for them to finish up and let me get back to moving.
Since I knew the radiologist through a friend I asked, “Tell me what you see. I’m not going to get crazy, but tell me what you see.” It wasn’t normal practice to answer that before the biopsy results were back, but based on the friendship, she did. “I think you have cancer.” I needed to get back to the movers and just said calmly, “Okay, let me know when the results are in.” I left and went back to my boxes. I didn’t think about it until I was on the long drive north to the mountains. That’s the first time it hit me, I could have cancer.
Denial and distraction were my major coping tools. I spent a lot of time just forcing the bad possibilities out of my mind, especially that weekend. I had plenty of other things to think about—unpacking, client work, starting life in a new location—it was easy enough not to think about cancer. But, a call on Monday morning confirmed the suspicion. It was stage 2 HR+, HER2 negative cancer. HER2 negative was good news, not as aggressive as some cancers, and the HR+ gave us more treatment options. My doctor wanted me back right away to meet with the medical team, including a surgeon, radiologist and medical oncologist. The plan was a lumpectomy and further evaluation after that.
After the surgery, I met with a doctor who was covering for my surgeon while she was on vacation. She assured me everything was fine and pointed out factors in the pathology report that suggested nothing further was needed. But a couple of weeks later, I met with the doctor who had actually done the surgery and she had a different opinion. She said the margins weren’t clear and she needed to go back in to do a second lumpectomy. I was stunned that the first doctor had been unable to read a pathology report, but trusted my surgeon—she had been recommended to me by the same friend who insisted on the 3D mammogram that started it all—so I went back in for a second surgery. Thankfully that one was good, so I didn’t need a mastectomy.
To Travel or Not
The next decision was where to have follow up treatment. The plan called for me to do chemo, radiation and then start on an estrogen blocker. I kind of assumed that since I was now living in a small town there wouldn’t be a sophisticated cancer center. But I talked to an oncologist I knew in the city—our kids had played soccer together—and he checked out the local facility for me. It turned out to be a wonderful place. It was connected to a major university and offering so many accommodations and supportive care treatments, like massage and acupuncture and exercise classes. My oncologist friend assured me it would be much better than traveling for care.
I had a lot of anxiety about losing my hair and feeling ill from the chemo, but handled it better than I anticipated. As I was told, there is no way to assess the impact of chemo until you’re in the middle of it. I sent my daughter and husband away on a trip we had planned to take together and just focused on what I needed to do without having to worry about how they were going to react to it all.
After the first treatment, I didn’t get out of bed for a couple of days. I had muscle and joint pain the doctor said was probably from the Neulasta they gave me to help me build back white blood cells that the chemo wiped out. So for the second chemo treatment, we tried doing without Neulasta. Unfortunately, my white blood cell count got so low that I was told I shouldn’t be out in public or eat fresh fruit and vegetables. I could get an infection that would kill me.
At the time, I was still busy as a lawyer and constantly handling papers. Paper cuts were a normal part of my life. But two had become swollen and red. They were clearly infected and when my fever spiked to 101.4, I left for the hospital, only a couple of miles away. By the time I arrived, my fever was 103. Turns out my white blood cell count was zero! I didn’t know it could get so low. I stayed in the hospital for three days while they gave me intravenous antibiotics, waiting for my white blood cells to recover.
Other than that, the chemo was not difficult for me. I was exercising, working and feeling pretty good through most of it. And I had a couple of wigs that covered the hair loss, which was every bit as complete as I had feared. Radiation also went smoothly—five days a week for six weeks, but only ten minutes each visit. I didn’t have any side effects or burns, and no real fatigue either. It was just a process I needed to go through. It helped that I had great support at home. My husband, daughters, mom, sister, even the dogs, all provided such loving care. And I kept busy. Many of my clients didn’t even know I had cancer.
More Dramatic Than Cancer
When the chemo and radiation were finished, the doctors started me on estrogen blockers, which caused more side effects than anything else. I’ve had chronic UTIs, to the point of delirium. There was one time when I was driving and I lost my ability to find my way. I ended up in a coffee shop and someone offered to call 911. I was taken by ambulance to the hospital where I was given a course of antibiotics and I was fine the next day. But that was a freaky thing.
Shortly after that, I went into a severe manic episode, leading to a diagnosis of bipolar disorder, all from the loss of estrogen. I had made it through cancer, but this was way more dramatic and life-changing than that. There was a really low period in my life for several months before things stabilized. I even had to stop working and go on disability. And this is my life now—bipolar disorder doesn’t go away. But in order to keep the cancer at bay, I need to stay on the estrogen blocker for a full seven years. It still gives me trouble every now and then, but I have promised to stay with it.
I had had a hysterectomy before the breast cancer because of giant fibroids which caused constant bleeding. Conservative approaches to address the bleeding had failed. After the hysterectomy (which went badly—they nicked my bowel and I nearly died from infections and other complications, including sepsis, pleurisy, pneumonia and a collapsed lung) my doctors recommended hormone therapy. The theory was that this would reduce the impact of menopause after the severe physical trauma suffered in the aftermath of my hysterectomy.
I think it set up a domino chain from there. I developed fibromyalgia which the doctor thought may have been a result of the trauma from the hysterectomy. I’ve had 17 different surgeries since then, mostly orthopedic related to torn tendons or ligaments not caused by any injury. One day, I just wake up and have severe ankle pain – torn tendon. Then I wake up with shoulder pain – torn rotator cuff.
There has been some suggestion that maybe I have a connective tissue disorder or something from the hormonal changes. But I also developed thyroid cancer and had to have my thyroid removed. And the hormones definitely contributed to the breast cancer. To top it off, the fibroids which were the reason for the hysterectomy in the first place, grew back. Once they reached the size of a softball, I had surgery again to remove them.
The things I worried most about when I was first diagnosed with cancer, like nausea with chemo and radiation burns, turned out to be non-issues, and things I never would have imagined, like the cancer itself, and the way my body responded to hormonal changes, have had life-changing impact. I wish I had been better informed going into it all.
A Global Reality
One of the many surprises about the whole experience was the liberating feeling that it gave me to speak my mind. I stopped putting up with crap from random strangers. And I learned how to advocate for myself with my medical team. I even stopped worrying about what others might think about my appearance. I suppose that was a good thing. And there is this incredible connection to everyone who had even had cancer or a friend or loved one who had cancer, even the professionals who treat it. It’s such a shared experience, a global reality, to have cancer.
I decided to write a book about my experience, as a way of processing my own emotions around the whole thing, but also to share some of what I had learned. It was my way of dealing with it—I was in denial while I was going through it all. But eventually you have to face what happened. And if I could make somebody else smile or have a little easier time of it, that would be a good thing.