There is a lot of breast cancer in my family history. My mother was diagnosed with the disease at 44, and my paternal grandmother died of breast cancer when she was just 33, so I’ve always been diligent about performing breast self-exams— often weekly—to ensure that if I did get breast cancer, it would be caught at an early, curable stage. I’ve also always lived a healthy lifestyle to reduce my risk of cancer and other diseases. A never-smoker and drinker, I made sure to hit the gym at least 5 days a week to retain my physical stamina and normal weight. I’m also someone who pays attention to the rhythms of her body, so, 4 years ago, when I started feeling bloated and fatigued, I pestered my general practitioner to perform some tests to see what might be wrong.
Beth Fairchild
Finally, 5 months later, she scheduled an abdominal and pelvic ultrasound, which showed that both of my ovaries were enlarged. Fearing the diagnosis might be cancer, I was sent to a surgical oncologist who, after additional imaging testing showed that my ovaries were so enlarged they were about to rupture, recommended a hysterectomy. But once the operation was underway, it was clear to the surgeon that although it looked like I did have some type of cancer, she was sure it wasn’t a gynecologic cancer. A pathology examination of the cancerous tissue determined that I actually had de novo stage IV estrogen receptor–positive, progesterone receptor–negative, HER2-negative lobular carcinoma with distant metastases. After all my vigilance to prevent breast cancer, especially late-stage breast cancer, my worst fear had come true. Imaging scans showed that the cancer was now also in my liver and throughout my bones.
At age 34, I was told I most likely had 2 years to live.
Wondering Why I’m Still Alive
FROM THE TIME of disease onset to diagnosis, I’ve never had a detectable mass in my breasts. In fact, a week before the surgery I underwent a mammogram just to be sure there were no signs of breast cancer, and the test was negative. Two years after my diagnosis, I insisted that I have a bilateral mastectomy, fearful there was a tumor hidden somewhere in my breasts, feeding the metastases. I desperately wanted to shut off the source of my spreading cancer, but the pathologist could find no cancerous cells in any of my breast tissue.
Six cycles of paclitaxel plus endocrine therapy and regular injections of zoledronic acid have kept my cancer stable. From the number of friends I’ve lost to breast cancer over the past 4 years, I know I’m an outlier and wonder why I’m still alive when so many others have succumbed to the disease.
Turning Metastatic Breast Cancer Into a Chronic Disease
ALTHOUGH GRATEFUL, of course, to have outlived my prognosis, I’m also angry. I’m angry about all the wonderful people cancer has taken too young and that more isn’t being done to stop metastatic disease in its tracks. I want to see more research funding go to discovering how to convert metastatic breast cancer into, if not a curable cancer, one that can be treated as a chronic illness that people can live with for a lifetime.
“Cancer has been a great awakening. Now, time is my greatest commodity, and I’m not wasting a minute.”— Beth Fairchild
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Because my cancer was incurable at the time of my diagnosis, I couldn’t relate to the issues early-stage cancer survivors were coping with, such as hair loss and negative body image, in the online support forums I visited. At least they will live, I thought. I would gladly be bald forever if it meant that I could see my children grow into adulthood.
Ironically, although those early-stage survivors were emaciated and sickly, I am the one, long blond hair intact and deceptively healthy-looking, dying. I channeled my anger into patient advocacy and joined METAvivor, Metastatic Breast Cancer Awareness, Research, and Support (metavivor.org), a nonprofit organization led by volunteers, most of whom are survivors of metastatic breast cancer, dedicated to raising awareness and funding for this disease.
I’m now President of METAvivor, and it is shocking for me to realize that although about 30% of patients with breast cancer will develop metastatic disease—6% to 10% of new breast cancer cases are diagnosed at de novo metastatic disease1—only about 5% of research funding is dedicated to finding more effective therapies for the cancer.2 We have to do better than this.
Giving Meaning to My Life
WHEN I WAS DIAGNOSED with metastatic breast cancer I was in the prime of life. At 34, I had all the time in the world, or so I thought. I was raising a young family; had several tattoo studios, which I’ve now dedicated to specializing in three-dimensional areola and nipple tattooing for breast cancer survivors; and had long-term goals of saving enough money to retire comfortably surrounded by my grandchildren. Now, time is my greatest commodity, and I’m not wasting a minute.
Cancer has been a great awakening. With death hovering over me like a ghostly specter, time is precious. I take advantage of that knowledge by never letting an opportunity go by to tell my family and friends how much I love them and spend my time doing things that give me the greatest joy. My advocacy work and helping other breast cancer survivors cope with their disease is at the top of that list, as is experiencing the everyday pleasures healthy people take for granted.
Although cancer may rob me of the future I thought I would have, it has given me the opportunity to live in the moment, making every minute count and living the most purposeful life I can. ■
Ms. Fairchild is President of METAvivor, Metastatic Breast Cancer Awareness, Research, and Support (metavivor.org). She lives in Greensboro, North Carolina.
REFERENCES
1. Metastatic Breast Cancer Network: Incidence and incidence rates. Available at www.mbcn.org/incidence-and-incidence-rates. Accessed September 24, 2018.
2. Sleeman J, Steeg PS: Cancer metastasis as a therapeutic target. Eur J Cancer 46:1177-1180, 2010.
Editor’s Note: Columns in the Patient’s Corner are based solely on information The ASCO Post received from the survivors interviewed and should be considered anecdotal.
