How to Move Forward From Cancer Diagnosis Day
On Nov. 20, 2023, my gynecologist called to tell me that I had breast cancer. I was 49 years old. In my head, that day will forever be “Diagnosis Day.”
The journey to diagnosis had started four months earlier, with my annual screening mammogram and ultrasound (because I have dense breasts). Something in my right breast looked different than it had the previous year, so the radiologist asked me to return for additional imaging.
At that time, my husband and I were packing for a long trip to visit my parents in Michigan; my mom was dying, and I didn’t know when I’d be back to South Florida – but I knew I would be gone for at least a couple of months. The imaging center couldn’t get me in before we left, and I was told it would be OK to wait for the additional diagnostics. On Nov. 1, after returning to Florida, I underwent follow-up imaging, which led to a biopsy a couple of weeks later.
Cancer “Diagnosis Day”
When my doctor called to tell me I had cancer, I was at home, alone. She asked me to sit down and said a bunch of words I didn’t quite process. She assured me the cancer was very small, told me to stop using vaginal estrogen right away and made an appointment to remove the hormonal IUD she had inserted just a few months earlier.
After I hung up the phone, all I could think was, “I don’t know if I’m up to handling this.” I’d just spent the previous three months living in my parent’s house with my husband, watching my mom die. She’d had ovarian cancer for more than two years (neither she nor I had any known genetic factors for cancer). I’d had COVID-19 and rebound COVID, and we’d had to put one of our dogs to sleep following a rapidly progressing case of dementia.
I was in mourning for my mom and my dog, still unpacking from my time at my parents’ house and trying to return to a regular rhythm of work after weeks of focusing on my family. I was worried about my newly widowed dad, whose children lived in different states. And now I had to navigate breast cancer treatment. How would I find the energy to do this?
Telling my loved ones I had cancer
I took a deep breath, walked across the street to mail a package (I was afraid I’d forget to mail it, and it had to be sent that day), then walked over to my husband’s office. I sat down in his guest chair and told him, “I have breast cancer.” I laid out what little I knew.
Then I went home and texted my younger sister, who lives in Minnesota. Once we got on a video call, I told her I had breast cancer. Together, we read my lab report and looked up what the results meant. It was all relatively good news: hormone-receptor-positive, HER2-negative invasive ductal carcinoma – likely easily treatable. The mass appeared small, and my cancer was considered stage 1. She said she’d come down when I had surgery.
Next, I called my best friend, who lives in Southwest Florida and had visited me for an overnight stay just a few days earlier. “Can you come back and give me a hug?” I asked her. “Because I have breast cancer.” Shortly thereafter, I called my closest local friend. Both friends were steady, offering me comfort and real promises of whatever help I needed. I knew I could and would ask for that help.
The most difficult item on my immediate checklist was to tell my dad, whom I video-called that evening. I shared what I knew and assured him that the cancer was small and early and my prognosis was excellent. I kept thinking, “It’s not like Mom’s cancer,” which had been two different rare types of ovarian cancer. By the time she was diagnosed, she’d had symptoms – mainly a stomachache – for a year. In contrast, I had been diagnosed with the most common, most studied, most treatable type of breast cancer. My dad also offered to come down when I had surgery.
A couple of days later, I shared my situation in a group text with several lifelong friends, who responded with love and support. I knew I’d never have to feel alone on my journey.
Making a plan for breast cancer survivorship
Even as I was telling the people closest to me that I had cancer, I was furiously planning in my head and making lists of questions and things to do along my treatment journey. Right away, I made two decisions: I would definitely get first and second opinions, and I would have a full mastectomy – not a partial mastectomy (also known as a lumpectomy). After all, mastectomy is a major surgery, and it would be better to go through it now than in 10 years or 20 years if the cancer came back. In my head, the only question the surgeon had to answer was whether it would be a double mastectomy. Spoiler alert: I was totally wrong about the best course of treatment for me. I was right about getting two opinions.
Seemingly backing up the decision I’d already come to about mastectomy, my sister asked me to read a blog an acquaintance of hers had written about her own breast cancer journey. She had decided to have a full mastectomy, and surgery revealed a cancer more advanced than her medical team had expected.
I didn’t read all the blog posts my sister wanted me to read. I’ve never been squeamish, but as soon as I started to read the details of the woman’s surgical recovery and her challenges, I started to feel nauseous. I decided right then that I didn’t need those kinds of details about anything I would be doing.
Waiting for oncology
For my “first opinion” appointment, I called the breast cancer group where I’d had my imaging and biopsy. Thanksgiving was days away, but I was able to get a new patient appointment about two weeks later. I knew I wanted a second opinion from Sylvester Comprehensive Cancer Center, our region’s only National Cancer Institute-designated cancer center. I filled out Sylvester’s appointment request form, soon received a callback, and made my “second opinion” appointment with Sylvester for the same day as the other appointment.
Then, I waited, and my thoughts turned to speculation. I knew I had a very early-stage and treatable cancer, and I knew I’d need surgery, but I didn’t know if I’d need chemotherapy or radiation. I had no idea how long treatment would run, nor any real sense of my prognosis.
Seeking advice on choosing the right surgeon (I realize how lucky I was to have choices!), I contacted an acquaintance who is a physician and a breast cancer survivor. During a long and wide-ranging conversation, she shared a great deal of valuable advice. The top two takeaways were to get a second opinion to make sure I had the correct diagnosis and to take the treatment journey one step at a time.
At that point, I tried to focus on enjoying a vacation and catching up with friends and clients I hadn’t seen in the past several months. I thought of my mom and cried.
Logically, I was pretty sure my prognosis was good. Still, there were nights I was too scared to sleep, terrified the cancer had metastasized or that it was otherwise worse than it appeared. I laid awake worrying about exactly what my treatment would be, what side effects I might experience, how many surgeries I’d ultimately need and how difficult my recovery would be.
I was also scared that I would die and the strain would deliver a brutal blow to my dad, my sister, and my husband.
Meeting the breast surgical oncologists
Finally, the day of my surgical oncologist appointments arrived. In the morning, my husband and I met with one surgeon, and in the afternoon, we met with the other. They both concurred on my diagnosis and my best course of treatment: an outpatient lumpectomy followed by radiation. This treatment has short-term and long-term outcomes, at least as good as mastectomy for my type of cancer. I probably wouldn’t need chemotherapy.
I was shocked and relieved to learn that my active treatment would be finished in less than six months. I decided to follow the recommendation from both surgeons since it was backed by solid research.
Just two weeks had passed since my diagnosis, although it felt so much longer. There was a lot I didn’t know – how the surgery would go, how I’d feel during radiation, whether I would ever stop being afraid. But, for the first time since Diagnosis Day, I had a clear plan.
I still had a lot of questions. But, I’d taken my first steps on my cancer survivorship journey.
It takes “a village” to get through the cancer journey. One of the best places Sylvester patients can build their village is by participating in classes, events and support groups. Nobody understands what you’re going through like your fellow cancer survivors.
Written by Rochelle Broder-Singer, a journalist with over two decades of experience in journalism and communications, for Sylvester Comprehensive Cancer Center.
Tags: Breast cancer survivor stories, Cancer diagnosis journey, Emotional impact of cancer, Rochelle Broder Singer, Sylvester Comprehensive Cancer Center
