A Moment in Time: The Survivorship Care Plan and Follow-Up Care as a Standard of Care

Barbara Unell PhotoBarbara C. Unell is the founder of Back in the Swing USA® and co-author of The Back in the Swing Cookbook: Recipes for Eating and Living Well Every Day After Breast Cancer. Ms. Unell wrote this blog post in anticipation of our upcoming town hall meeting, Survivorship 360: Navigating Your Way Through the Re-Designed Breast Cancer Roadmap.

I love the new song, “3 Things,” by Jason Mraz. In fact, I love it so much, that I decided to make it the theme of this blog, using a bit of poetic license to play off of Mraz’s message. He sings about the three things that he does “when his life falls apart.” 

His words resonate with me today, as I reflect on this particular moment in time in the history of breast cancer survivorship healthcare, a field in which I have planted seeds, along with hundreds of caring volunteers, dedicated healthcare professionals and generous sponsors, for the past 15 years.  I hope that you will take a moment (3 minutes, actually) to sit back, listen to Mraz’s song and be inspired, too.

The song’s lyrics remind me of my “new life” that started in the exhilarating days of 1999, after my treatment for breast cancer, when I was focused on “changing the conversation” between physician and patient. As an author, educator and social entrepreneur who is committed to translating scientific research into practical action, I was determined to move that conversation for consumers of cancer healthcare from the anxiety-filled moments of asking, “Now what?” to the confident steps of receiving a comprehensive, personalized survivorship care plan and follow-up recommendations during and/or after primary treatment ends. Continue reading

Hear My Voice: Getting the Support You Need as a Young Mom With Metastatic Breast Cancer

photo-1terriYoung mothers living with metastatic breast cancer face unique hurdles and uncertainty. Terri da Silva provides insight on these issues and shares resources and tips for supporting your family while living with this diagnosis. 

Living with breast cancer is tough. It’s especially difficult when you’re a young woman trying to navigate your way through adulthood, building a career, starting a family, and then you find out you have metastatic breast cancer. The kind that rarely goes away. The kind that requires lifelong treatment. The kind that is terminal.

I was diagnosed with metastatic breast cancer in 2011 at the age of 37 when my daughter was only 2 years old. I had no previous breast cancer scares. No family history. I was otherwise healthy. Suddenly my life was flipped upside down.

Young moms with metastatic breast cancer face a unique set of hurdles. Unlike most breast cancer patients whose treatment has a prescribed end date, those of us with stage IV metastatic disease live our lives going from one treatment to the next. Praying the treatments will slow down or stop the progression of our disease long enough so we can see our kids learn how to ride a bike, go on their first date, graduate from school. Praying the side effects from our treatment won’t cause us to miss soccer games and parent-teacher nights. Praying our loved ones won’t tire of supporting us year after year after year. Praying for the strength to make the most of each day we are still here. Continue reading

Hear My Voice: How I Manage Scanxiety

LBBC Board Member Amy Lessack writes about how she manages her emotions before and after she gets scans.

“You must be freaked out every time you get a scan and have to see the doctor.”

If you are a breast cancer survivor or someone living with metastatic breast cancer, this is something that well-meaning people say because they probably don’t know what to say.

The obvious answer is, of course, I am concerned and worried. You pray to whomever, whatever to get the clean scan and the OK from the doctor that you are good for 6 months, a year, or even more.

No one ever asked for breast cancer. I certainly DID NOT invite it in my life, and it needs to go. However, that is not my journey.  I continue to be on the roller coaster of vacillating between the 3-month and 6-month of scans and back to 3-months. So how do I handle it, manage my emotions and get through it? I get through using the following seven steps before every scan:

#1           I had to make a conscious choice – “scans are my friend.” Why are they my friend? Because they are the only things that can “see inside my body” and help the doctors and me cheer when things look good, and research or make a plan when or if necessary.

#2           I now schedule my scans on Mondays and doctor appointments the Friday after the scan. This is so that I don’t have to wait to hear the results knowing that it takes 2 – 3 days to get them.  Continue reading

Hear My Voice: Living the Life of Clichés (That Are True)

LBBC Blog - Scott Cotlar%27s PhotoScott Cotlar writes about living by common clichés for people affected by metastatic breast cancer.

When I was first diagnosed with metastatic male breast cancer, I was not prepared to make any major changes in my life. There were just a few small lesions in my lungs. I was fully functional, working full-time as an attorney and had no interest in changing my daily routine.

That was about 6 years ago. Fast forward to today – lesions in my lung are “too numerous to count” according to the radiologist’s report; 5 bouts of gamma knife radiation of the brain for a total of 13 lesions treated; radiation to most of my spine; and now large metastatic lesions in my liver. Even with all of this, my good quality of life did not change until…a lesion on my tibia (a bone between the knee and the ankle) gave me an “elevated risk for fracture,” requiring that I wear a leg brace and walk with a cane.

The lesion to my tibia was the game changer. All of a sudden, my quality of life was deeply affected: the simple act of walking was no longer quite so simple. I felt an urgent need to “get my affairs in order.” As I write this blog I am preparing for chemotherapy, which I have done my best to avoid for the past 6 years, taking advantage of any hormonal or targeted therapy that I could get my hands on. I am finally starting to feel like a “real cancer patient.” Continue reading

Hear My Voice: How Far We’ve Come and Where We Need to Go

MBC Medical Expert Julie Gralow MDJulie Gralow, MD, blogs about the advances we’ve experienced in treating and managing one subtype of metastatic breast cancer, and calls for more support in research and care for people affected by the disease worldwide.

 

Substantial advances have occurred in the field of breast cancer during the 20 years I’ve been caring for people diagnosed with metastatic disease. I had a chance to reflect on this last month, when I saw a woman newly diagnosed with breast cancer whose sister had also been a patient of mine. The sister died of metastatic breast cancer in 1995 at the age of 35. There were few effective treatments at that time, and despite access to state-of-the art care and enrollment in a clinical trial, her survival following recurrence was short.

My current patient accompanied her sister to many of those last clinic visits. Memories of those visits were prominent in her mind when she was diagnosed with breast cancer in 2014, at the age of 47, and became a patient herself. Both sisters were diagnosed with HER2-positive breast cancer, but there were no approved HER2-targeted therapies in 1995. In 2014, there are four approved therapies and others in development. What used to be an aggressive type of breast cancer with a poor prognosis has now become much more treatable and survivable. This woman’s outlook is tremendously hopeful.

Thanks to the Human Genome Project, we no longer think of breast cancer as a single entity, or its treatment as “one-size-fits-all.” Our increasing understanding of cancer genomics has revealed multiple subsets of breast cancer with different behavior patterns and different responses to therapy. Dozens of new agents have been approved for the treatment of metastatic breast cancer in the past two decades, offering meaningful improvements in the likelihood of response and length of survival. Continue reading

Hear My Voice: Relationships, Faith and Being Declared NED

Serenity KislingSerenity Kisling blogs about navigating her relationships, her strong faith and being declared no evidence of disease.

 

As I write, it’s the first day of 2014’s Breast Cancer Awareness Month. I’ll be honest: now that I’ve been declared NED (no evidence of disease), I don’t want to watch the Today show’s #PinkPower, or think about cancer. I am so traumatized by the last 7 years, and wondering if I was going to see my son’s third, fourth, fifth, sixth and seventh birthdays.

However, I want to reflect on my journey. Despite what I have experienced with my health and my family, I got through this journey with metastatic breast cancer through faith, laughter and by living my life.

First, let me say that the breast cancer journey sucks, no matter if you are lesbian or straight. I was initially diagnosed with stage III ER/PR-positive breast cancer in 2008, at age 35. I had a 2-year-old son and a different partner at the time. At that point, my relationship with my partner was rocky, and she was not very emotionally supportive while I had breast cancer. She had no idea what I was going through: being bald from chemo, becoming so sick because of the chemo that I could not drink or eat anything, ending up neutropenic, dehydrated and in the hospital for a week and developing pneumonia.

In 2009, my then-partner and I celebrated when oncologists declared me in remission. We thought life would go back to normal and not the “new normal” commonly associated with post-treatment — just “normal,” period. It seemed like I was better after finishing treatment. I even went back to my hardcore workouts. But then I started feeling fatigue, and with that came insomnia. Life became miserable for various reasons, and I decided to divorce my partner. It was the hardest decision I have had to make thus far in my life. Through all of this, maintaining my positivity (though hard at times) and my faith got me through this major life change.

Something that made me depressed was that the oncologist who declared I was in remission did not discuss preserving my fertility before I proceeded with chemotherapy, and now it’s too late. I had been in survival mode, I had a beautiful son, and having another child hadn’t crossed my mind. I wish now I had frozen my eggs. I would have loved for my wife to carry my child. Even though I live with this regret, I have come to realize that it may not have been meant to be, and I must accept this and cherish my one beautiful son. Continue reading

Hear My Voice: Dealing With the ‘What Ifs’ Before and After ‘I Do’

LBBC blog pic_AyannaAyanna Phillips writes about how she and her husband overcame the what-ifs and lived their lives together after her diagnosis with metastatic breast cancer.

 

“To join with you and to share with you, all that is to come…”

While going over our wedding vows, this was the part that was hardest for me. What a loaded statement given our circumstances. There were moments while I was planning our wedding that I was consumed with joy knowing that I had found my soul mate. I never thought I would love so deeply, trust so willingly and laugh so hard. There were also extremely difficult moments when I just about drove myself insane. What if the pain of my most current metastasis to my bones prevented me from walking gracefully down the aisle as I had dreamed? (I had acquired quite a limp at the start of the summer because of the disease in my hip.) And the one that kept me sleepless in bed a few nights after slaving over DIY projects and the perfect shade of pink…What if I get sick and we have to cancel the wedding?

Trying to balance my diagnosis and my thoughts on forever didn’t just start with our wedding. I was diagnosed just one month after our engagement. While most women are basking in the glow of their recent engagement and diving head first into the sea of planning, I was forced to put all thoughts of a wedding on the back burner and focus on my health. It felt like all the things we planned to do might never come to be. The what-ifs that come with a metastatic breast cancer diagnosis can rival the worst day in treatment sometimes. Continue reading