I have a history of fibrocystic breasts, which required biopsies to make certain the cysts were benign, and for years they were. But in 2009, my mammogram screening picked up a suspicious lump in my right breast, which turned out to be stage III estrogen receptor–positive/progesterone receptor–positive, HER2-negative breast cancer.
Because I had such advanced disease, my oncologist devised an aggressive treatment plan to halt its progression. It included a full mastectomy, followed by 12 weeks of doxorubicin and cyclophosphamide, then 12 weeks of paclitaxel, and 6 weeks of radiation therapy. She also suggested that I take an aromatase inhibitor for 5 years, but the joint and muscle pain was so extreme I choose to stop taking it. Although I stopped taking the aromatase inhibitors after just 2½ years, my oncologist has told me that the damage to my joints is irreversible.
Living With Metastatic Breast Cancer
Despite all the treatment and my medical team’s vigilance, in January 2015, I learned that the cancer had metastasized to my liver and thoracic vertebrae. I was enrolled in a clinical trial investigating GDC-0810 (ARN-810), but after 3 months, my tumors progressed. I was prescribed palbociclib (Ibrance) in combination with letrozole, and not only did my cancer progress on that treatment as well, the letrozole exacerbated my joint pain, making it even more difficult to walk.
I’m now taking capecitabine, and my most recent blood marker test is showing tumor activity. So I won’t be surprised if my next imaging scans show that the cancer is continuing to advance, although I truly hope the drug is working.
Trying to Maintain Quality of Life
When you have cancer, you not only have to deal with all the attendant problems of the disease, but with the bureaucracy of health insurance as well. Recently, I received notice that my insurance company is dropping my provider and treatment center from my health plan. As a former psychiatric nurse, I’m not easily intimidated by the medical establishment and I’m pretty good at self-advocating, but finding a new medical team after being treated by the same one for 7 years is daunting.
For me, enduring the cancer treatments and their horrible side effects is more challenging than having the disease. I’ve never felt any pain or discomfort from my breast cancer, even now after it has spread to other parts of my body. It is the side effects from the many treatments I’ve had over the past 7 years that have had the greatest impact on my life. I had such cognitive decline after my initial therapy of doxorubicin and cyclophosphamide, I thought I had had a stroke and have not regained the cognitive status I had before cancer. The thought of having to take additional intravenous chemotherapy is discouraging, frustrating, and quite challenging.
Facing an Uncertain Future
Despite all I’ve gone through and what may lie ahead, I’m trying to stay positive and not make cancer the center of my life. My Buddhist faith keeps me grounded, and I’m buoyed by the support I receive from my son, my co-housing family, and friends. I’m grateful that I have a roof over my head and food on my table, and I try to concentrate on all the wonderful aspects of my life rather than dwell on my cancer. Focusing on what I can do about my illness—eating a healthy diet, exercising, and meditating—rather than on what I can’t do is powerful.
Although I’m not exactly sure what I’m facing, I’ve learned to be okay with whatever the future brings. When I look at all the suffering around the world, I feel lucky. Even if I die from cancer, I still consider myself fortunate to have had the life I’ve had. ■
Janice Kennedy is a retired psychiatric nurse. She lives in Seattle, Washington.
