In August 2015, Judith Smith was diagnosed with a type of breast cancer called mixed ductal and lobular carcinoma. A week later, her sister, Dianne Marks, received shocking news: she, too, had breast cancer -- specifically infiltrating duct carcinoma.
The two sisters are only 14 months apart in age and have always been close. They both live in Port Arthur, just a little over an hour outside of Houston, and they both work as nurses. Eventually, they found comfort in their shared diagnosis.
“It ended up being a good thing,” Dianne says.
While Judith went through radiation first and could help Dianne prepare, Dianne had surgery first and was able to help Judith prepare.
“We were able to share our stories,” Judith says.
The differences between their treatment exemplified how MD Anderson breast cancer experts used personalized care to help both sisters overcome cancer.
Judith’s breast cancer treatment
After an abnormal mammogram and an ultrasound, Judith came to MD Anderson. While scheduling her appointment, she learned that MD Anderson has a location in League City, a suburb closer to her home. She decided to seek treatment there.
Judith saw breast cancer surgeon Cristina Checka, M.D., who performed two separate needle biopsies at two different appointments after the first one showed that they needed to test deeper. The second biopsy confirmed Judith had breast cancer. By that point, Judith knew she was in good hands.
“I knew when I met Dr. Checka that she was the absolute best doctor for me,” she says.
Checka’s warmth put her at ease and the two spoke about their family, their faiths and football. Checka collaborated with oncologist Amy Hassan, M.D., to create Judith’s breast cancer treatment plan.
“My treatment was targeted and set up to be what was right for me,” says Judith, who underwent chemotherapy every three weeks for six months. “It was pretty rough, but I was still able to work.”
During the first phase of chemotherapy, her side effects included abdominal pain, constipation, nausea and fatigue. The second phase was harder. Judith developed mouth sores that made it difficult to talk and eat, but eventually, they subsided.
With chemotherapy behind her, Judith began preparing for surgery. She was given the option between a mastectomy and lumpectomy. Ultimately, she chose a partial mastectomy, in which only the tumor and the part immediately surrounding it are removed.
Judith was able to go home shortly after the outpatient surgery. The next morning, she felt well enough to get out of bed and put on makeup, impressing her adult children on their video call.
Once she had recovered, she underwent five weeks of daily radiation therapy in Port Arthur.
Throughout her treatment, Judith quickly realized that talking with others about her experiences helped her cope.
“It gave me some peace and relief,” she says.
Of course, talking with Dianne helped the most.
Dianne’s breast cancer treatment
“It wasn’t an imposition at all to drive to MD Anderson, and it was worth it to see the best,” she says.
As a nurse, Dianne knew how common breast cancer is, but she never suspected that she had it. She was too worried about her sister’s diagnosis and her daughter’s upcoming wedding.
When Dianne’s team at the Cancer Prevention Center told her she had breast cancer, they referred her to Mariana Chavez Mac Gregor, M.D., an oncologist. The transition was seamless, but Dianne wasn’t ready to focus completely on her own cancer care. At this point, her daughter’s wedding was just a week away. Dr. Chavez Mac Gregor listened to Dianne’s concerns and determined that since the cancer wasn’t aggressive, the could delay her breast cancer treatment.
After the celebration, Chavez Mac Gregor helped Dianne determine that the best treatment plan for her was participating in the LORELEI trial. This clinical trial was designed to determine if combining the drugs letrozole and taselisib helped reduce the size of the breast tumor.
Diane was unsure about participating in a clinical at first, but a coworker pointed out, “You could really help someone else.”
Dianne took the drugs daily for 16 weeks, and her tumor shrank almost 80%.
After chemotherapy, she had a partial mastectomy, followed by four weeks of radiation therapy. Having just watched Judith recovery from the procedure, Dianne had a better idea of what to expect. Knowing that the recovery process would be quick helped put her mind at ease.
With the clinical trial, surgery and radiation behind her, Dianne prepared for the next part of treatment: an additional four rounds of chemotherapy to ensure that the cancer would not come back. About three or four days following each chemotherapy treatment, Dianne started to feel nauseous and fatigued, but little by little she felt better.
Once chemotherapy was complete, Dianne began taking a maintenance dose of letrizol, the same drug she took at the beginning of her treatment. She continues to return to MD Anderson for checkups every six months.
Like Judith, Dianne kept working throughout her treatment.
“I didn’t feel I had to put my life on hold,” she says.
Personalized care for breast cancer treatment
Despite both having breast cancer, the sisters’ cancer treatments differed greatly because their doctors coordinated their care and developed a comprehensive treatment plan unique to each of them and their diseases.
“While I’m a nurse, I’m not an oncology nurse and there was a lot I didn’t know about cancer treatment until Dianne and I were diagnosed. Seeing the difference between each of our treatment plans really helped me better understand personalized care,” Judith says. “There’s no one-size-fits-all.”
Not even for sisters.
I felt a lump in my right breast one day and knew it wasn’t normal. So, I went to my primary care physician. She ordered a diagnostic mammogram, and a biopsy to confirm it. Then she referred me to a local oncologist.
Originally, I’m from Chicago, but I’ve lived in eight different cities since then. So, while I’d probably heard MD Anderson’s name in passing, I was completely unaware that it was the nation’s top-ranked hospital for cancer care. That’s why I didn’t even think of it when I was diagnosed on Dec. 27, even though I live just down the street.
Today, I am so glad that I landed there. Because I am fairly picky, and everyone on my team at MD Anderson was amazing. I don’t believe in flukes, so I attribute my guidance there to the hand of God.
Quick self-referral process swayed me
One of the things that astonished me most was how responsive everyone at MD Anderson was.
I learned that I had breast cancer at 3:30 on a Tuesday afternoon. I couldn’t eat or sleep that night, so I went online to do some research. Then, somebody in a cancer forum wrote, “You know, you live in Houston, so you might want to check out MD Anderson. It’s considered the best in the world.”
I went to the website and filled out MD Anderson’s online form in middle of night. And to my surprise, someone called me early the next morning. She said, “We got your application, but I have just a few more questions.” After I answered them, we hung up. A few hours later, she called me again. She said, “OK, we have a team mobilized, and an opening on Jan. 2. Can you be here?”
My breast cancer treatment
The rest, as they say, is history. At MD Anderson, a team of doctors including Dr. Nuhad Ibrahim recommended a mastectomy, followed by six months of chemotherapy. A tissue expander would be installed during the surgery and replaced with a permanent implant later on. The only good thing about my cancer was it had not spread to any lymph nodes, so Dr. Welela Tereffe said I wouldn’t need radiation therapy.
I had the mastectomy on Feb. 7, 2017, and my last dose of chemotherapy on Aug. 31, 2017. That was only days after Hurricane Harvey made landfall in Houston, and a lot of places in the city still had high water issues. I was one of the first patients let back into the hospital for treatment afterward. My permanent implant was installed on Nov. 2, 2017.
A cheerleader for breast self-awareness
I’ve been cancer-free now since Feb. 7, 2017. So my holiday season this past year was amazingly great compared to how it was three years earlier.
But the only reason I even knew I had cancer was because I noticed a change in my breast. Cancer doesn’t run in my family, and mine was fast-growing and aggressive. It was already sizable by the time I found it. That’s why I encourage other women to be on the lookout for changes, too. Cancer can show up even between your annual mammograms, so it’s important to know your breasts.
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