Breast Cancer Survivor
Nancy Weatherspoon is diligent about her health. She regularly checks her breasts for lumps or other unusual changes. One day she felt a lump. She did not tell her doctor, nor her family or friends. She hoped it was nothing as she waited for her routine yearly mammogram.
Two days after her annual mammogram, Nancy received a letter from the imaging center stating that there were “two findings” in her right breast and she needed to come back for an ultrasound and a diagnostic mammogram.
Nancy saw a radiologist for the ultrasound-guided biopsy. She couldn’t help but ask, “What do you think it is?” Nancy recalls the doctor saying he thought it was very worrisome.
“Then the doctor handed me a long-stemmed white rose,” she says. For Nancy, that white rose meant more than what the radiologist had intended. It was very frightening to receive in fact, because in the church where she grew up, Mother’s Day was celebrated with roses. Red roses were for those whose mothers were alive and white roses were for those whose mothers had died. Looking at the white rose she’d just been handed, Nancy remembers thinking, “It is very worrisome.”
Nancy’s pathology report confirmed that she did in fact have breast cancer – invasive ductal carcinoma. Her primary care doctor told her that Seattle Cancer Care Alliance was the best place to go for treatment.
“From the day I called Seattle Cancer Care Alliance I felt like I was in competent hands,” Nancy says. “I didn’t have to worry about a thing. SCCA was always just a phone call away.”
Nancy and her husband went through the Breast Cancer Specialty Clinic conference with Benjamin O. Anderson, MD, surgical oncologist, and Hannah M. Linden, MD, medical oncologist. Together they came up with a plan of action to treat Nancy’s cancer.
“I remember arriving at SCCA and my name was on the exam room door. I met my doctors and learned that we had caught my cancer early. It was treatable,” Nancy says.
Nancy’s cancer was estrogen-fed so she stopped wearing the estrogen patch she had worn for years. She had an MRI (magnetic resonance imaging) and a PET scan (positron emission tomography). “I also had genetic counseling because of my extensive family history,” Nancy says. “If there was a genetic connection, it would have meant a double mastectomy and having my ovaries removed.”
But the testing didn’t reveal the genetic markers that are currently known to be associated with heritable cancer risk, so in July 2006, Nancy opted to have a lumpectomy and six weeks of daily radiation therapy.
In September after surgery and radiation treatment, Nancy began treatment on a clinical study “MA 27” with Dr. Linden that tested two different types of aromatase inhibitors.
“Nancy volunteered to participate in this large national study looking at two different types of adjuvant endocrine therapies for breast cancer,” says Dr. Linden. “The aromatase inhibitors have displaced tamoxifen, but are still newer drugs in need of study.”
Estrogen-receptor positive patients usually take five years of estrogen blocking or estrogen lowering medications. Tamoxifen is a blocker where aromatase inhibitors are estrogen-lowering drugs.
“The study gave patients five years of pills, randomized between steroidal AIs (aromatase inhibitors) and nonsteroidal AIs,” Linden explains. “This is like testing the difference between aspirin and ibuprofen. One binds irreversibly to the aromatase enzyme, the other binds transiently. Both are (and were at the time of the study) FDA-approved treatments.”
Studies like this help physicians learn about breast cancer treatments as they try to make incremental improvements. The study ended and results showed the two were equivalent to one another.
In January 2007, Nancy felt another lump, this time in the other breast. Dr. Anderson did a fine needle biopsy and three days later Nancy was in the emergency room with an infection that would cause her trouble for several months. Under the careful surveillance of Dr. Anderson and Dr. Hakim Said from UW Medical Center, Nancy’s infection was resolved.
Recalling a time during her treatment for the infection when her husband had to leave town, Nancy was alone and the drain tube had fallen out. She struggled to put it back into her breast, but could not get it to stay in place. “And infection gunk was draining out!” Nancy says. Living in a remote area of Washington, feeling frustrated, and “just sick of everything,” Nancy called SCCA for help.
“It was Dr. Anderson who answered the phone!” she says. “I had called his office after hours on a weekend and he was there. The ’big’ oncology surgeon answered his office telephone and walked me through my crisis. He was kind, caring, and very understanding.”
By the end of June, mammograms of both breasts gave Nancy reason to celebrate. No cancer.
Cure, Compression Garments, Caring
“Dr. Linden called my five-year mark, ‘Cure!’” Nancy says, giving her time to write her books and screenplays instead of worrying about cancer.
Nancy was on a book tour, in fact, when she was diagnosed with cancer. She has plans for a book that she hopes will “communicate medical information and survival tips with the kind of sharing a woman acquires from useful chatter among her women friends,” she says. Nancy wants to write her book from the point of someone who understands that surviving an illness as emotionally and physically traumatic as breast cancer involves help. That help involves not only serious issues but also petty concerns, like compression sleeves.
One of the side effects of treatment for Nancy has been lymphedema, for which Dr. Linden prescribed physical therapy and compression garments. Nancy will wear compression garments for the rest of her life and prefers to wear a black sleeve instead of the usual flesh colored one. “I know it is petty,” she says, “but the compression garments are available in pretty colors! Thank you SCCA for that info.”
Little touches mean a lot, especially to someone with cancer.
“I expected to get a message machine when I telephoned SCCA and I talked with my surgeon. That is the care I found at SCCA,” Nancy says. “From the nurse who came out to greet me with a hug, to the way everyone said hello. I come to SCCA by ferry and car, and if I was late or early for an appointment, they worked me in. That’s SCCA to me. It’s a great machine. They’re very good at their jobs but they’re more than that—they are above and beyond. Even the people in the gift shop set aside some hats especially for me just because they thought I’d like them! I believe in SCCA so much.”