Steven
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After Steven’s wife felt a lump in his breast, he went to an academic comprehensive cancer center. In a single day the team hastened the diagnostic testing to accommodate his vacation plans. Tests entailed a mammogram, giving him a close-up view of “what women go through,” an ultrasound, and biopsies of the lump and sentinel node. He was diagnosed with Stage 3 triple positive (ER, PR, HER2) breast cancer and left for the planned vacation to visit one of his sons and family for two weeks. He so grateful that the team accommodated his plans and for that time in the warm weather with family. Chemotherapy started immediately upon his return, with the aim of shrinking the tumor before surgery. Steven’s son, it turns out, was a first-year oncology fellow at another comprehensive cancer center and was another set of eyes throughout Steven’s breast cancer experience. He encouraged Steven to look into his family history and have a full genetic panel; read more about Steven’s experiences with inherited cancer risk here.
Throughout his treatment Steven clung to his oncologist’s words, “your life is mine for a year, and then you go live your life.” It was a very tough year. He had just retired to enjoy life—going duck hunting, traveling and visiting family—not “to take on another full-time job,” as a cancer patient. Yet, it was the cancer treatment and recovery that occupied all his time. The 21-day chemotherapy cycle entailed the first few days with no side effects, followed by two weeks of weakness and misery, and just when he started to feel okay, it was time for the next treatment. In the midst of chemotherapy, Steven acquired a near-fatal sepsis infection, requiring hospitalization. Although he grew extremely thin and weak, chemotherapy shrunk the tumor. Surgery, a single, radical mastectomy, that removed twenty-three nodes, which thankfully all were clear. Despite chronic fatigue and need for skin care, the month-long radiation treatments were the easiest part of his cancer treatment journey. He now takes tamoxifen to reduce his risk of recurrence and has had no side effects. Steven also does physical therapy and weightlifting to recover his strength.
Steven counts the support of his wife, family, friends, faith community, and two dogs that dearly love him as essential to enduring his cancer year. The visits and meals allowed his wife to continue working her demanding job. Despite having gone through tough times with treatment, Steven never stopped living or doing fun things watching sports or going out for lunch. Thanks to his and his hunting companions’ ingenuity, he was even able to go duck hunting with his chemotherapy port. After his last treatment, Steven and his wife are planning a long-hoped for and well-deserved trip to New Zealand, a place with deep family ties. And they hope to go to Europe the next year.
Steven notes that talking to people who share the cancer experience is so helpful. Reflecting on the young girl he met at the radiation clinic with brain cancer, no hair and a positive attitude, Steven says, “no matter how bad you think you might have it, there's a lot of people out there that have things far worse.” He also says talking to a woman with breast cancer experiences was helpful, because she “knew exactly what I was going through.” He notes, “if you have never really gone through it yourself, you can be sympathetic and empathetic, but you really don’t know exactly what a person is going through.”
Once he was able to see his doctor, Steven quickly had the necessary tests and received his diagnosis.
Once he was able to see his doctor, Steven quickly had the necessary tests and received his diagnosis.
I guess my story starts probably late October of 2017. And my wife felt a lump in my breast and asked me, have you ever felt this before? And I said no. I contacted my doctor and made an appointment. And of course, I couldn't get in until the first week of December. And at that point, he said, “Well, I don’t,” he said, “I don't like this. I want you to go to [LOCATION] and have an ultrasound.” And they scheduled that pretty quickly, like a week later, within a week. And I went in, and they said, “Well, we're not going to do an ultrasound. We're actually going to do a mammogram.” I had the wonderful experience of knowing what women go through when they have a mammogram. And I report it to the Breast Center downstairs at [LOCATION] Hospital and went back to the clinic. And they came in, and they’d had a radiologist read the results. And then he said, “Well, we'd like you to come back this afternoon at 1 o'clock, and now we're going to do the ultrasound.” I went home, and I came back. And I did an ultrasound and went across the hall to the clinic and waited. And then they came in and they said, “Well, we'd like to do a biopsy.” And my visit that started at 9:00 o’clock in the morning was now going to take the entire day because it took until about 3:30 for them to get me to do the biopsy. And they biopsied my tumor, and they biopsied a sentinel lymph node. Tomorrow will be one year to the day that I got my diagnosis when they called and said, “You need to come in.” The results weren't what, obviously, everyone hoped for.
Steven had extensive skin pain, which he managed with skin creams.
Steven had extensive skin pain, which he managed with skin creams.
You get like a sunburn where the radiation is being directed on your chest and on, on your upper back. And it takes a couple weeks after radiation stops for that to start to subside. Because you still have been exposed to all that radiation. And oh, it's not like, “OK, we stopped yesterday, so today it’s going to be perfectly fine.” It takes two weeks for the radiation to start, you know, losing its effect. And then it took probably a couple weeks after that for, you know, the redness to disappear. My radiation oncologist said a lot of people actually get sores, open, that ooze fluids. Mine didn't get that bad. I was really careful about using really good skin creams on all my radiated areas multiple times a day. That made a huge difference in how I reacted to the radiation treatments, and I think how quickly I recovered as well.
For Steven, chemotherapy was delayed to rebalance the electrolytes in his blood.
For Steven, chemotherapy was delayed to rebalance the electrolytes in his blood.
Because I had so much GI distress, I was draining out all my electrolytes, my magnesium, and potassium, which are really important to your heart health as well. I was only having chemo once every three weeks. But after about the third treatment, I was going in to infusion a minimum of two to three days a week for four to six hours minimum just to get electrolytes put back into me because my magnesium got really, really low, and they were pretty concerned. And at one point, they actually delayed one of my treatments by a week. And instead of giving me a treatment, I got a blood transfusion, which was a positive thing. I mean they don't do transfusions lightly. But I mean, there's a lot of beneficial effects, and I certainly felt stronger after I got my two units of blood.
Steven says he didn’t experience side effects from tamoxifen.
Steven says he didn’t experience side effects from tamoxifen.
I have to take tamoxifen, which is a, suppresses estrogen production, for five years. I started it about a week or two weeks after my radiation ended. And so, I've been taking it for a couple months. And, you know, just another pill so.
Have you seen any side effects from that?
I haven't. Apparently, ironically, they told me one of the potential side effects is hot flashes. And I said, “In men?” And they said, “Yes, men too.” But I have not had one.
For Steven, high quality care was care that took account of his life priorities.
For Steven, high quality care was care that took account of his life priorities.
Well, and I mean there were certain things that I set as goals. And one of them was we've gone up to [LOCATION] the last, late June every year for a week. And we've rent a cabin, and we fish and swim, and, and do all that kind of stuff. And that's why I didn't want anything happening to my surgical date because I wanted to be healthy enough to go sit in a fishing boat. And I was able to do that. I wasn't as strong as I would have liked to have been, but I got quite a bit of fishing in.
Did you catch any fish?
Yeah, it wasn't really a very good week, but we caught some. I caught some pretty nice bass. I had that, and we were able to do it. So, you know, that was something I had-, I had strived to be able to do, and we were able to do it. And my surgeon bent over backwards to make sure that it could happen. Again, because when they postponed the surgery, she said, "Well, you don't have to worry about that." She said, "I will get you in the schedule. I don't care what the schedule says. I will get on the schedule, and you will have your surgery."
Steven’s wife did all she could to prepare meals he could eat.
Steven’s wife did all she could to prepare meals he could eat.
It was pretty hard to make a meal for me because everything during those the first part of every cycle, everything tasted so bad. I mean, it got down to, “OK, I can eat mashed potatoes, and I can eat noodles and rice.” You know, it had to be a really bland diet. And I could get a little bit of chicken in there once in a while, but that was about the only protein.
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I'm sure that was really frustrating for her, trying to, you know, help me find things that I could eat--because I needed to eat to keep my strength up. But I couldn't stand to eat. And so, she would, you know, made things, and then I would take two bites and push my plate away and say, “I'm sorry. That's all I can, I can’t, I just can't stand it. I can't eat it.” And I mean, these were all foods that I would normally like anyways. So, that was pretty frustrating.
Steven says that the support of his church congregation “has been a blessing.”
Steven says that the support of his church congregation “has been a blessing.”
The people that we know well at church and the leadership of the church all know that I have it because we do quite a bit of volunteer work. They've been really supportive. Having their support has been a blessing. I mean the power of prayer cannot be discounted. Having people pray for you and praying yourself is a very good thing.