As many are aware, October is breast cancer awareness month. As part of our recognition of this disease and the need for early detection, Mammoth Hospital welcomed Jennifer James, author, artist, and breast cancer survivor, to our community to speak about her journey. I had the distinct pleasure of sitting down with her to discuss in more detail everything she went through to get to the point where she is now a 6-year survivor!
Can you share with us how and when you were first diagnosed with breast cancer?
JJ: In July 2016, after turning 40, I had my first screening mammogram, which was negative for cancer. I figured I was in the clear. I had done my mammogram right on schedule, and no cancer meant back to business as usual, or so I thought…
What happened then?
JJ: Not even a year later, in the spring of 2017, I found a mass the size of a golf ball in my right breast. Having had a negative mammogram the previous year, I was not sure how something could show up and be that big that fast! Immediately, I made an appointment to see my primary care provider, and she referred me for a diagnostic mammogram. This was on April 13, 2017. During that mammogram, the radiologist on duty came in to talk with me about her findings. She said there was a suspicious mass, and I needed an Ultrasound Guided Core Biopsy. That was scheduled on April 28, 2017. She also told me that even in retrospect, there were no suspicious findings on my mammogram from the previous year.
On May 1, 2017, I was notified that the biopsy was positive for cancer, and the next step was a targeted mammogram. I was diagnosed with triple-positive Invasive Ductal Carcinoma. Ultimately, my oncologist and surgeon confirmed that my type of cancer explained why the abnormal mass had grown so quickly and was more aggressive.
Did you follow up with your primary care provider with the result?
JJ: No, I did not. I was in the Kaiser system at the time, so there was constant contact with whoever was going to do the next step.
So in some ways, it was like being seen at a comprehensive breast cancer center?
JJ: You could say that. One of the great things about my experience was always being notified about what was going on. If I was told I was going to get a call about a biopsy or MRI, or doctor’s appointment, I got that call. There was never any guessing about what was going to happen next. Kaiser did a wonderful job guiding me through the process, and I never felt alone or lost.
On May 4, 2017, I had a targeted mammogram of the mass on the right. Then, on May 10, I had an ultrasound of the left breast to make sure that side was clear, along with a Stereotactic Breast Biopsy on the right to see if any additional spots needed to be biopsied. Luckily, the cancer was contained within a single tumor.
On May 11, 2017, I had my first appointment with the breast surgeon, who in turn referred me to an oncologist. They both told me that they work hand-in-hand with each other, and that must be true, because they each laid out an identical treatment plan for me!
The oncologist scheduled me for chemotherapy, starting June 6, 2017. Prior to that, I met with a genetic counselor, had an ultrasound of my heart to make sure I could tolerate the treatments and had a port implanted in my chest for the infusions. I was to have one treatment of chemotherapy, then have three weeks off to recover from all the side effects, for 6 cycles. This went on until September 19, 2017.
The chemotherapy worked – my tumor shrank down to the size of a pea, and I was then able to have a lumpectomy, a type of breast sparing surgery, as opposed to a full mastectomy. This was on October 25, 2017, almost six months after my diagnosis was initially made!
I continued with the Herceptin infusions because of the cancer markers I had for a total of 12 doses, 3 weeks apart, and finished my last dose in June of 2018.
This truly was an all-encompassing battle! What happened after surgery?
JJ: My surgeon and my oncologist gave me about 6 weeks off to recover. I had a follow up with my surgeon on November 2, 2017, where I was told there was no residual cancer. I was started on Tamoxifen on November 20, 2017, which I still take today. Then, I was scheduled by my radiation oncologist to have radiation therapy to my right breast, part of my lung on that side, and under my arm due to where the cancer was located. Radiation therapy started on December 4, 2017, which consisted of radiation 5 days a week for a total of 20 doses. My last round of radiation was in January of 2018!
What an incredible battle. That must have taken a lot of strength to get all the way through to the end. Looking back at the entire journey, we have a few questions. First, why did you see the surgeon first?
JJ: It wasn’t necessarily my choice but the schedule that was created by my medical team. But honestly, I was hoping the surgeon would just cut the lump out and I would be done, avoiding chemotherapy and radiation. I could not have been more wrong! Over the course of the next several months, fighting this disease became my full-time job. It seemed like every time I turned around, I either had an appointment, a procedure, a chemotherapy treatment, radiation, or follow up. All told, I was in this fight from the beginning of April 2017 until June of 2018 when I finished Herceptin and had my port removed – around fourteen months! Even now, I still take Tamoxifen and have follow up appointments. But as I said, my surgeon and my oncologist worked very closely together, so in the end I am not certain it would have mattered which doctor I connected with first.
Was it easier for you to be in the Kaiser system for this?
JJ: For me, it was. All of my providers worked so closely together, so I never felt lost or ever wondered what was going to happen next. The communication and the support were amazing, and I am truly grateful for my surgeon, oncologist, and medical team.
At Mammoth hospital, we do not have all the resources that Kaiser or a comprehensive breast center has. But we do have other resources, like an oncology nurse navigator. Her job is to reach out to our cancer patients, keep them on schedule, communicate with treating physicians out of the area, and provide chemotherapy infusions right here in Mammoth under the direction of the treating oncologist. Perhaps most importantly, she is the contact person for our cancer patients when they have questions, feel lost, or maybe just want a shoulder to cry on.
JJ: That would have been a wonderful resource, even in my journey through the Kaiser system. Going through this battle is one of the hardest things I have ever done, but going through it alone would have been a nightmare!
Is there anything else that could have gone better for you?
JJ: Not really, I think my experience was as good as it could have been. I wouldn’t wish it on anybody, but as I said, when you learn that you have cancer, your first thought is that your life, as you know it, will change forever. But you must hold on to the idea that this is a fight you can win. It’s a mindset. I realized it was ME against IT. To overcome something so life-altering, it takes a village of support from family and friends to my team – doctors, surgeons, nurses, literally anyone and everyone who played an important role in my care. Looking back, I think I would have liked to have talked with my primary care provider when I was first diagnosed since I had been her patient for over a decade and loved her, and then perhaps a few touch-base visits along the way, but I cannot overstate how amazing my care team was.
For all of us at Mammoth Hospital, we thank Jennifer for sharing her story with us. If you want to learn more about her incredible experience, please read her book “Feisty Righty: A Cancer Survivor’s Journey,” available on her website, feistyrighty.com, or through Amazon and Barnes and Noble.
Early detection saves lives, so please make an appointment with your primary care provider through the patient portal, or by calling 760-934-2551 to schedule your cancer screening tests. If you are going through treatment for cancer, please let us help! Our Oncology Nurse Navigator is Lisa Marusicz, and her phone number is 760-924-4055.