From the moment I felt a searing pain go through my right breast, I had a premonition that something was very wrong. Although I couldn’t feel anything unusual when I did a breast self-exam, I made an appointment with my gynecologist for a more thorough clinical breast exam and a mammogram. Because he could feel no palpable masses and I was just 37—too young for a mammogram for someone with no family history of breast cancer—he said my health insurance wouldn’t cover the cost of the test. But my sense of dread that I would be dead before I turned 40 if I didn’t have the test was so strong, I wouldn’t take “no” for an answer.
Finally, the doctor agreed and wrote me a prescription for a mammogram. However, because there were no physical signs of breast disease, the test was scheduled for 4 months later. The week leading up to the mammogram, I again felt a jabbing pain in my right breast; as I instinctively grabbed my breast, I could feel a lump along the chest wall.
Marie Elaine Price-Lockridge
The mammogram confirmed a tumor. The pathology report from the tissue biopsy found that I had stage I hormone receptor–positive, HER2-negative invasive ductal carcinoma.
I had a lumpectomy, followed by twice-daily brachytherapy radiation for 5 days and four rounds of a combination chemotherapy regimen of doxorubicin and cyclophosphamide. The treatment was so brutal, I had to reduce my hours at work by half, but it kept me in remission for 15 years.
Living the Roller Coaster of Metastatic Breast Cancer
In the summer of 2019, I was treated for unrelenting migraine headaches, but they continued to plague me into the fall. Then, one day, as I was getting dressed for work, I felt something snap in my breastbone and noticed that my ribs were hurting. The pain became so debilitating, I finally went to the emergency room, where a computerized tomography scan showed I had a broken collarbone and several fractured ribs. Additional imaging found metastatic lesions throughout my bones and skull. The breast cancer had recurred.
By the time the metastasis was discovered, the bone pain was so excruciating, I was nearly wheelchair-bound. I was sure I would soon die. I had lost my husband to cancer 2 years earlier and felt very alone and scared.
My oncologist prescribed the kinase inhibitor palbociclib in combination with the aromatase inhibitor letrozole. I soon went from being unable to stand upright to walking 3 miles a day. The change was nothing short of miraculous, but my sense of relief was temporary. A magnetic resonance imaging scan of my brain showed the cancer had penetrated my skull and was in the dura membrane, which put me at risk for leptomeningeal carcinomatosis.
A lumbar puncture was performed to test my cerebrospinal fluid for malignant cells. Initially, I was told the test had turned up a small number of cancerous cells, which meant I could be dead within 3 months. The news brought me to my knees. I can’t adequately describe what it is like to know you have a finite time to live.
Five days later, my oncologist called to tell me he had run the thought-to-be cancerous cells through different diagnostic screenings. Although the cells were abnormal, they were not cancerous. I had escaped death—at least for the moment.
A year ago, I had radiation on the lesion on my dura membrane, and the cancer remains stable. Although leptomeningeal carcinomatosis is a rare complication of cancer—it occurs in about 5% to 8% of patients with solid tumors1—patients with breast cancer and other cancers need to be aware of meningeal symptoms, including headaches and seizures, so they can get necessary treatment to extend their lives for as long as possible.
Living Fearlessly
When I was diagnosed with metastatic breast cancer, I believed I had only a short time to live, and maybe that’s still true. But then I found my courage and told myself that I was not going down without a fight. I would repeat this mantra over and over: “Not today, cancer, not today.”
I understand the precarious health situation I’m in. But rather than focus on my terminal status, I prefer to think of myself as living with a chronic disease and live every day as if I don’t have cancer. I’m not naive; I just want to enjoy every moment I have left.
REFERENCE
1. Batool A, Kasi A: Leptomeningeal carcinomatosis. StatPearls Publishing, 2021. Available at www.ncbi.nlm.nih.gov/books/NBK499862/. Accessed July 1, 2021.
Ms. Price-Lockridge lives in Phoenix, Arizona.
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.
