Steven

Age at interview: 67
Outline:

Cancer runs in Steven’s family. His dad died of colon cancer and his mom of metastatic breast cancer. About one year ago, Steven was diagnosed with Stage II breast cancer and tested negative for genetic mutations. He had chemotherapy, a radical single mastectomy and radiation; he takes tamoxifen.

Background:

Background: Steven is a White man who lives in a Midwestern city with his wife and two dogs.

Cancer-Related Experience: Cancer

Type of Inherited Risk: Family history of cancer

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About a year ago, Steven’s wife felt a lump in his breast. His doctor referred him to an academic comprehensive cancer center where he had a mammogram, which let him “know what women go through.” After an ultrasound, and biopsies of the lump and sentinel lymph node, he was diagnosed with Stage II triple (ER, PR, HER2) positive breast cancer. He was 66, had just retired and was about to drive to Florida for a long visit with his son and family. He appreciates how accommodating the cancer team was in quickly scheduled everything, so he could leave as planned for vacation and start chemotherapy immediately upon return.

It turns out that Steven’s son was training to be an oncologist and was interested in knowing about the genetic family’s cancer risk. Steven’s father died from colon cancer and his mother died from breast cancer that had spread to her bones. So, Steven agreed to test for the full genetic panel. During his first chemotherapy infusion, the genetic counselor came in and said, “Well, you're not going to believe this, but all 28 genes came back normal.” Steven was relieved, and so were his three sons, to not have those abnormal genes to the family.

Steven recalls his oncologist saying, “Your life is mine for a year, and then you go live your life and enjoy it.” And that’s what he clung to during that tough year. He, “wasn't expecting to retire to take on another full-time job.” But that’s what he did, Chemo was tough. The 21-day cycle started okay with no side effects for the first few days. But soon the side effects kicked in and he was weak and miserable for a couple of weeks and he started to feel good just before the next treatment. Chemotherapy caused a near-fatal sepsis infection and the cumulative effects left him extremely thin and weak. But it shrunk the tumor. Surgery, a single radical mastectomy, ended up more extensive than they had hoped. They took 23 nodes (4 sentinel and 19 axillary), which ended up being clear. He’s been doing physical therapy to rebuild his strength and to minimize the scar tissue. The 28 days of radiation were the easiest to tolerate of the three treatments, although he was tired all the time and had to care for his skin.

His wife, family, friends, and faith community were all supportive during his treatment, allowing his wife to continue to work at her job that required travel. He was able to go duck hunting, with his port, thanks to his ingenuity and his hunting companions. As he closes in on the last of his treatment, Steven and his wife are planning an exotic trip to New Zealand, a place with deep family ties.

 

 

Steven’s test results came as a relief.

Steven’s test results came as a relief.

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And they also had me, one of the tests that I had done was the, the genetic testing. And they had ordered tests for three things, but there's apparently the panel, I think is 27 or 28 genes, that they really can look at, and they know that those genes actually have a relationship with cancers. And so I was asked if I was willing to have all of them tested. And I thought, “Well, why wouldn't I? Why wouldn't I want my family to know, you know, if I had any abnormalities or whatnot?” And as it turned out, I had my first chemo on January 5, and the geneticist came in and saw me during infusion. And she said, “Well, you're not going to believe this, but all 28 genes came back normal. So we really don't why you have cancer. You're kind of an outlier. It's, you know, just one of those things.”
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The fact that the way my genetics turned out was really good, my son, who's going to be a cancer doctor who has two daughters, was extremely interested in the genetics results. Because if some of those results hadn't turned out so good, that would have carried through in the genes to him and to my two granddaughters. Then it would have been something that they would have had to start dealing with at, you know, at age, what, 19, 20, 21. They would have had to start being tested. But now, since, you know, I came back negative, that was a huge relief to his family.

 

Steven’s breast cancer diagnosis came after he became symptomatic and underwent a number of tests.

Steven’s breast cancer diagnosis came after he became symptomatic and underwent a number of tests.

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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 so 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.” So I had the wonderful experience of knowing what women go through when they have a mammogram. And so I report it to the Breast Center downstairs at [LOCATION Hospital], 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.” So 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 so 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.

 

Steven says his doctors time his treatment according to his wishes.

Steven says his doctors time his treatment according to his wishes.

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And then it’s-- 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. And so they said that the tumor in my breast was cancerous, and that the lymph node that they had biopsied also had stray cancer cells in it. So it had already started to spread a little bit. And at that point, I had just retired. I retired September 29. And I chose that day because it was the day before duck hunting opened, and I love to duck hunt. So duck hunting wrapped up the first week of December, and then all of this started taking place. And we'd already rented Airbnb’s to go down and visit my son, my granddaughters, and the family that lives down in [LOCATION]. So when I met with my doctor, [NAME], it was amazing how they bent over backwards to accommodate me as much as they could. I mean, she, we were there on a Friday afternoon when she was giving me the diagnosis and all of this. And at 5 o'clock in the afternoon, she had her scheduling nurse come in to get my, all the tests done that they wanted done the next Monday morning because I was supposed to have left on Saturday to go, we were driving down to [LOCATION].
And so they got everything scheduled. And then we left for [LOCATION] that afternoon. And I was only able to stay for two weeks because my chemo started on January 5th.
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I mean, and there were certain things that, you know, 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 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.
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So 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.”