Two weeks after the lumpectomy, I saw my surgeon for a post-op appointment to get the stitches out and hear the results.  I went alone, on my lunch break.  Why would I be concerned if my surgeon was also convinced it was a benign tumor?  The doctor entered the exam room with his head hung low.  When he finally looked up he softly said, “I am sorry but I have a bit of bad news.  You have breast cancer”.

My heart sank and tears spilled out.  I was completely devastated.  Two thoughts immediately hit me.  I am going to die and there goes my boyfriend. 

Up until that point in my life, my knowledge of cancer was from television; you get sick, throw up, lose your hair, turn a pasty color and become a skeleton until you die.  My boyfriend, also 24, had just started a great sales career.  What guy would want to deal with cancer in a relationship at such a young age?  Mentally, I wrote him off right then and there.  I wouldn’t blame him for backing out of our relationship.

But Chad didn’t leave me.  As soon as he heard my voice message, he walked off his job and came straight to my house.  He took me by the hand and declared,” Come on, we’re going for a ride”.  As we drove aimlessly around the neighborhood he gave me a lifesaving pep talk that set the tone for my fight against cancer.  “We are going to get through this,” he said.  “We will get you the best doctors and the best treatment.  We are going to beat this and then get on with our lives.”

This was a vital moment in my life and I will never forget his strength and determination.  Before this conversation, I was definitely the pessimistic, glass half-empty kind of girl.  Chad made it clear that we would overcome this horrific news and take the high road in our attitudes.  No “poor me” syndrome.  He loved me and was promising to support me.  I was overjoyed!

And so, my journey began.  My pathology report concluded a stage two cancer with one positive lymph node in my armpit.  I chose a lumpectomy with radiation versus a mastectomy.  I was single, after all and dating!  Since it was technically my second lumpectomy, quite a bit of tissue was removed for clean margins. Therefore, the cosmetic results were very distressing.  I was left completely lopsided with a C cup and an A cup.  Chad was sweet and lovingly began to refer to my revised breast as “half pint”.

Chemotherapy lasted seven months and radiation was two months.  I experienced the gamete of symptoms-nausea, fatigue, hair loss, mouth sores, low blood counts, shortness of breath and insomnia.  My family had a hair-cutting party where Chad shaved my quickly disappearing hair.  Of course, he messed around a bit by creating a mohawk before the final buzz.  Chad and I wore matching baseball caps throughout my treatments.  He constantly left little notes, poems and flowers for me.

The best part about having cancer (did I just say that?) was Chad. The morning after my first chemotherapy, Chad came over with a dozen red roses and some funny movies to watch together.  I was in my pajamas and I had been throwing up.  So, needless to say, I wasn’t looking my best.  After I set the roses on my desk, I got back in bed.  Chad’s expression was one of disappointment.  So, I asked him what was wrong.

“You didn’t look at the flowers close enough.”  He got up, retrieved the flowers and set them, once again, in my lap. Confused, I dramatically smelled them with a murmur of the wondrous fragrance and again commented on how beautiful they were.  What did he want me to say?

He finally pointed to one of the roses.  It was a fake red velvet ring box in the shape of a rose.  I was stunned.  He got down on his knees and proposed. “Yes, yes, yes!” I cried.

A few lessons were learned during those first few years after my cancer diagnosis. Depression hit me hard, as it does many survivors.  Instead of feeling elated at winning my battle, I was terrified it would come back.  I began to let fear live my life.  Chad turned me around with a blunt statement: “You could also get hit by a bus tomorrow”.  I worked hard mentally at retraining myself to be positive.  After a while I got the hang of it and began to enjoy life again. I stayed focused on planning our beautiful wedding, which occurred on March 9, 1996.

I also started volunteering for the American Cancer Society, counseling other newly diagnosed survivors.  I loved it so much I then became involved on the local Unit Council, working my way up to President.  I volunteered for every program and event.  Making a difference in my community became a passion.  I was a patient advocate and I encouraged others to be as well.  There is nothing more rewarding than volunteerism.  It does wonders for one’s health and spirit.  I recommend it to everyone!

I would love to say my story ends here.  However, four years after my initial diagnosis, a routine mammogram detected some micro calcifications that proved to be a recurrence of breast cancer.  Now 28 years old, I couldn’t believe this was happening again.  I thought I had paid my dues in the “tragic events” part of life.  My emotions were pure anger.  I was furious!

After the initial temper tantrum and sob session, I went into fight mode.  This time I had no choices.  Due to the little breast tissue I had left, a mastectomy was my only option.  On the bright side, this time I would get a newly reconstructed breast at the same time.

The procedure, called a TRAM flap, is a major surgery.  A football size portion of my stomach, including muscle, fat, blood vessels and skin were removed and relocated to my chest.  Since it is my own tissue, the cosmetic results were fabulous.  It looks, feels and sags like a real breast!  What a concept.  But that is not the best part.  I got a tummy tuck out of this whole deal.  And believe me, I had some fat to spare! Another perk to having cancer!

I learned early on in my cancer battle that humor is needed for survival. Before I went under the knife for my mastectomy, I wrote a message on my breast for the surgeon – “Hasta La Vista, Boobie”.  He and the surgery staff loved it.

When explaining my reconstruction procedure to a friend, she looked horrified at hearing about all the rearranging that went on with my body parts.  She asked, “So when you get hungry, does your boob growl?”  Another friend asked, “When you do push-ups does that mean you’re doing sit-ups as well?”  I wish.

The next five years were spent in remission.  I was working full time as an office manager, volunteering for the American Cancer Society and public speaking for many arenas.  In 2001, I accepted a job with the American Cancer Society.  It is extremely satisfying to work for an organization I feel passionate about.

Unfortunately, in 2003, at the age of 34, I felt a lump in my neck.  Hence, my biggest recurrence- it had spread to the lymph nodes in my neck and cervical spine.  My oncologist informed me the cancer had advanced to stage four now that it was in my bones.  At this stage, I was told; cancer is no longer curable but can be managed.

For the next two years, I endured multiple chemotherapies as cancer popped up in various other places in my bones- lumbar spine, hip joints, thighbones, etc.  It became a game: I would have a recurrence, we’d flood my body with chemo which would work for a while, but then cancer would outsmart it again and pop up somewhere else.  I call it a cat and mouse game.  After a couple years, I began to have vision problems so I went to my eye doctor.  I thought I might be headed for prescription glasses.  Instead, I was completely shocked to hear my breast cancer had spread to the back of my eye.  Who has heard of such a thing?

In light of this new development, we decided to get a brain MRI as well.  Four lesions were visible and ranged in size.  Unbelievable. It just kept coming!

I have to say, at this juncture, I felt sheer panic for the first time.  Brain lesions could mean a whole new dimension of symptoms-memory, balance, taste, smell, seizures, stroke, and most importantly death.  I could go at any minute! I was terrified.  Suddenly, the clock was ticking on my life and I still had so much to accomplish.  Chad and I were talking about adopting.  I had started writing a book.  What if I don’t get to tell my family things I have wanted to express but couldn’t for some reason?  All these thoughts consumed me.  I was scared and overwhelmed.

So, before I started whole brain and eye radiation, I sat down and wrote each person in my family a letter in case I suddenly left this world.  They are sealed and stored in my twin sister’s safe if that time ever comes. When I finished, I felt a huge weight lift off me.  “Now I can concentrate on my treatments,” I thought.

Whole brain radiation was the toughest part of my journey thus far.  Three weeks of frying my brain and eyeballs.  That can’t be good, right?  The worst part were the effects of the steroids, which were required to reduce brain swelling and the chance of seizures.  Steroids caused excitability so I never slept and I ate everything in sight due to the increased appetite effect.  I blew up like a balloon in a few short weeks and gained 20 pounds.  Due to my swelling body, I lost sensation in my legs.  They felt like dead weight and I constantly feared falling.  I would literally have to lift my legs with my arms to put them in the car.  My Mom drove me to work everyday for three months until the feeling went away.

Yes, I continued to work full-time.  No matter how tired I was, I loved my job and it gave me purpose.  In my six years with the American Cancer Society, I never missed work unless I had a chemo or radiation appointment.

After radiation, my hair was a disaster.  It grew back much thinner with a nice obvious bald strip down the center of my head.  My niece called it a slip-n-slide, my husband called it a landing strip. I cope by covering it up with the Donald Trump comb-over.

At some point during one of my recurrences (I tend to lose track after so many), I attended a conference in Denver on Metastatic Breast Cancer.  One of the physician specialists talked about hormone receptors.  Most breast cancers are fueled by estrogen.  So, hormone manipulators called aromatase inhibitors can stop the flow of estrogen, which, in turn, can stop the cancer from spreading.  Unfortunately, my pathology reports performed at my initial diagnosis showed my cancer was “hormone negative”.  Therefore, aromatase inhibitor therapy would be pointless.  But, at the conference I learned one new interesting fact- having become the cancer expert by then, I knew everything else!  Ha!  Apparently, if you have been living with metastatic breast cancer for many years (by then I was almost at the 10 year mark) sometimes the hormone receptors can flip.  It was recommended that if there were any palpable masses to biopsy, it might be beneficial to get it rechecked.

Well, I took that little piece of information back to my oncologist in Southern California and shared my news.  He shrugged and said he had never heard such a thing.  I told him I wanted one anyway. He agreed, as he always does, to my requests.  He learned a long time ago that I am a very proactive advocate and always did my research.  Luckily, I just happen to have a big mass under my collarbone (luckily?  Okay, poor choice of words).  So, off I went for a biopsy.  Guess what?  I was right.  My receptors had flipped.  I was now hormone positive.  Oh, how tempting it was to say, “I told you so” to my doctor!  ☺  In a crazy way, this was good news.  I now had another tool to manage my cancer.

For two years, my disease “stabilized” with hormone manipulation therapy.  The only downside is the drugs have put my body into a chemically induced menopausal state.  I never thought I would be experiencing hot flashes and night sweats alongside my Mom.  She thinks it’s cute.  Also, constant bone aches and joint pain make me feel like I have the bones of a 90-year old lady.  Thank goodness I look great on the outside.  ☺ 

Bone scans show severe degenerative disease. Not good at 37.  But I’ll deal with that when it starts affecting my mobility.

My latest recurrence involved two of my previous brain tumors that decided to light up with activity on a routine scan.  So in July 2007, I underwent Stereotactic Radiosurgery (high dose targeted radiation to specific spots in the brain).  Then, in December 2007 I underwent 2 and ½ weeks of radiation to a mass under my collarbone.  It seems my body will require periodic maintenance for the rest of my life.  As long as these quick oil and lube jobs don’t interfere with the love and laughter in my life, I am fine with it.

Exercise and healthy eating are keeping my bone pain to a minimum and my energy level high.  My husband set up a home gym for us and I work out with weights and the spin bike 4 times a week.  We eat healthy and take lots of vitamins.  Hiking is our favorite activity we do together on the weekends.

Sadly, I am not able to have children due to all the treatments I have endured.  I will be on some form of treatment for the rest of my life.  But, Chad and I are considering adoption.  I have learned that cancer has become less of a deadly disease and more of a chronic one.  I am living proof of this because I am a 14-year survivor with 9 recurrences.

My biggest lesson?  Hope and hopelessness are both a choice.  So, why not choose hope?  It takes just as much energy to be positive as it does to be negative.  And optimism sure makes the process a little easier.

Heather Warrick

A.k.a. Cancer Princess (with so many recurrences, I though I deserved the title)