Jamil Rivers
When I was diagnosed with metastatic breast cancer in 2018, my first thought was, I hope my three young children do not lose two parents to cancer. My husband, Ricky, had survived two bouts of cancer, early-stage colorectal cancer and, most recently, stage I kidney cancer. Like Ricky’s two previous cancer diagnoses, my diagnosis was a complete shock.
I was just 39 when a lingering cold and cough sent me to my primary care physician for a checkup. She prescribed medication to ease my symptoms, but when it failed to suppress my constant coughing and sneezing, she set up an appointment for a chest x-ray. Because I was having mild pain on my right side—and I have a family history of gallbladder problems and appendicitis—the doctor also scheduled an abdominal ultrasound of my gallbladder and bile ducts.
Both the chest x-ray and ultrasound detected suspicious lesions in my lungs and liver. Additional imaging tests, including a mammogram, picked up lesions everywhere in my body except my spine and brain. A biopsy of a 3-cm mass in my right breast and a lesion in my liver determined that I have de novo stage IV estrogen receptor–positive, progesterone receptor–positive, and HER2-negative breast cancer.
Hiding Cancer
At the time of my diagnosis, I was entering an especially exciting time in my life. We had recently moved to a new town, where I had taken a position as Chief Financial Officer (CFO) at a nonprofit organization that supports educational programs in schools. Life’s possibilities seemed limitless. Now, I not only worried about how to stay alive, but whether the cancer diagnosis would jeopardize my livelihood and crucial benefits like health insurance. I was so concerned the diagnosis would cost me my job that I didn’t tell anyone at work I have cancer. When chemotherapy took my hair and eyebrows, I camouflaged the baldness with a wig, tattooed eyebrows, and went to work every day.
I was prescribed paclitaxel and, after 1 year of treatment, all my tumors had disappeared. I am now taking a combination therapy of palbociclib and letrozole, and imaging scans every 3 months continue to show no disease progression.
Buying Time
I’m not naive about my prognosis. I know the median overall survival for de novo metastatic breast cancer is less than 3 years, but, today, I am focused on living my best life. That doesn’t mean my life is without fear. I feel fear before every new imaging scan, and the relief I feel afterward is all too short-lived. But I’ve learned to talk over my fear with my oncologist. Together, we have come up with a plan for once the cancer becomes active again. Knowing we have a plan in place that can buy me some time and bridge me to the next effective treatment is comforting.
Thriving With Cancer
To help give me a better chance at keeping this cancer at bay for as long as possible, even though I do not have the BRCA1/2 gene mutation, I opted to have a risk-reducing bilateral salpingo-oophorectomy to suppress estrogen production, which has thrown me into surgical menopause. Since the surgery, I feel I have aged substantially, and I’ve had to learn how to cope with the attendant side effects of treatment-related menopause, including hot flashes, joint pain, and vaginal dryness. I also continue to have chemotherapy-related neuropathy in my hands and feet, and I’m learning to live with those issues.
But the bottom line is, I’m alive, and not just alive, but living a highly productive life.
Cancer has focused my attention like nothing else ever has and opened doors I never thought possible. Since my diagnosis, in addition to continuing my career as CFO, I’m also using my voice as a cancer survivor to help advance public policy, medical research, and better patient support. My goal is to meet the needs of people facing a metastatic breast cancer diagnosis, especially people of color, who often have to contend with an unequal medical system and worse outcomes than White patients.
Earlier this year, I launched The Chrysalis Initiative, which provides mentoring services to women with breast cancer, outreach and education for Black women to assess their breast cancer risk, and training in patient navigation. I’m also a board member of Living Beyond Breast Cancer (www.lbbc.org) and President of the Board of METAvivor Metastatic Breast Cancer Research, Support, and Awareness (www.metavivor.org).
Being involved in these organizations gives me insight into the extraordinary research being done in metastatic breast cancer. It also gives me hope for the future, not just for myself, but for the approximately 22,000 women and men who are diagnosed with de novo metastatic breast cancer each year in the United States1 as well.
Living a Life of Gratitude
Cancer has made me cognizant of time, and I’m careful not to waste any of it. I’ve learned to let go of the people and things that don’t bring me joy and also learned to be kind to myself when I don’t accomplish all the goals I’ve set. Cancer has also made me grateful. I’m especially grateful to my oncology team for their compassion and partnership and to all the researchers who are working so hard to keep me and the millions of other cancer survivors alive and thriving.
I’m also grateful to be able to work from home during the COVID-19 pandemic and to have health insurance. I’m grateful my children are healthy and adjusting to the confines of life’s new normal until the pandemic ends.
I know my disease is unpredictable and the future is uncertain. But today, I’m living the best life possible. I’m a fortunate woman.
REFERENCE
1. Metastatic Breast Cancer Network: Incidence and Incidence Rates. Available at http://mbcn.org/incidence-and-incidence-rates/. Accessed November 13, 2020.
Ms. Rivers is Chief Financial Officer of Education Works and President of the Board of METAvivor Metastatic Breast Cancer Research, Support and Awareness. She lives in Drexel Hill, Pennsylvania.
Editor’s Note: Columns in The Patient’s Corner are based solely on information The ASCO Post received from patients and should be considered anecdotal.
