I’m 35, With Stage IV Breast Cancer

Last December, six months after I married my husband, Lee, I discovered an unusual mass. After a local doctor told me "girls my age do not get breast cancer," I boarded the train to New York City for an appointment at the NYU Clinical Cancer Center. I went to see Dr. Richard Shapiro, a breast and oncological surgeon who had previously operated on two close relatives. On Jan. 8, he diagnosed me with inflammatory breast cancer.

I am writing to tell you that young women can and do get breast cancer. The impact of a cancer diagnosis varies by patient. In my case, I was a 35-year-old newlywed who hoped to honeymoon in Costa Rica, purchase a house, and start a family. All of my dreams were dashed when I learned that I had stage IV breast cancer. I don't know what was worse: the fear of not living long enough to achieve lifetime goals or the fear of painful medical treatments and dying young.

My medical odyssey began a year earlier in my home state. I had seen numerous physicians for a variety of symptoms including chest pains. My local doctors failed at all points, from prevention to early detection to diagnosis. I was a high-risk patient due to family history, but I was never given a mammogram until after I found the mass. If you think you may be at high risk, insist on getting a mammogram. My maternal grandmother died from ovarian cancer and my paternal grandmother died from breast cancer, but I was not informed about genetic-testing options until after my cancer diagnosis. Know your family history. If your mother, sister, or daughter has had breast cancer, consider genetic counseling. Even with films that showed an inoperable tumor, I was initially referred to a general surgeon at a local hospital without a cancer center.

I knew something was seriously wrong, and I acted on that instinct when I came to New York City. I was unsure how it would be possible, but it was important to me to be treated by the doctors that I trusted at NYU. I am currently undergoing radiation treatment and still living in New York City 10 months later. I am deeply grateful to the American Cancer Society who generously provided me with accommodations.

Cancer treatment has improved significantly since my grandmothers' time. I am indebted to the multitude of patients who came before me who participated in medical studies and the doctors who conducted this important research. Shortly after diagnosis, I undertook a series of tests to guide my treatment plan. There are many classifications of drugs and oncologists today know which chemotherapies will have an effect on specific tumor types. My chemo cocktail included both standard treatments and drugs recently out of clinical trials. Although chemotherapy has greatly improved, the drugs are still highly toxic and can have serious side effects.

The chemotherapy was effective in shrinking my tumor and my body tolerated the drugs. Once the tumor was operable, I progressed to surgery. Armed with the knowledge that, like 5 to 10 percent of breast-cancer patients, I carry the BRCA gene, I know that I will need additional surgeries in the future.

As a cancer patient, it is your responsibility to advocate for your own health. I believe my local doctors were well intentioned; if they had been better informed, perhaps they could have identified my cancer at an earlier stage. By the time I received my diagnosis, the breast cancer had already metastasized. Metastatic breast cancer accounts for about 30 percent of breast-cancer cases. For this patient population, cancer is treatable but not curable. At best, it can be managed like a chronic condition. For me, the decision between being treated at a major cancer center or a local hospital was a matter of life or death. I am thriving today because of the choice that I made and the talented and knowledgeable doctors who cared for me.

When we made our marital vows, my husband promised to be with me in sickness and in health. It never occurred to us that sickness, in the form of a life threatening illness, was just six months away. What should have been our first year of marriage became my first year of survivorship. When we had planned to travel for our honeymoon, instead my husband helped me move into the ACS/Hope Lodge. We had hoped to purchase a home when our lease expired, now with a new lease on life I look forward to the day I can finally go home again with him and claim whatever bits of happily ever after are left for us.

© 2009