Personalized breast cancer treatment kept me in the race

Breast cancer is one of the most common types of cancer, but when I was diagnosed with it in November 2016, it didn’t feel that way. I was only 35 and single with no children. I was also globally ranked in the IRONMAN triathlon.

Initially, I thought I wouldn’t be able to have children or do another IRONMAN. So having breast cancer treatment tailored to my unique needs was very important. I wanted doctors who would consider all the angles and let me be a part of the process. Because even if your cancer diagnosis is common, there are still a lot of choices and challenges that are unique to you.

That’s why I absolutely love the doctors and staff at MD Anderson. They treated me as an individual, and were kind and empathetic. Even the people at the front desk remembered my name.

Most importantly, my doctors took my age, lifestyle and goals into account, and developed a plan that fit me perfectly. And while it included some standard treatments (chemotherapy, double mastectomy, radiation therapy and breast reconstruction), the details were tailored to me.

Step 1: Preserving my fertility after my breast cancer diagnosis

A cancer diagnosis before age 40 presents some unique challenges, including potential fertility loss from chemotherapy. So, I met with Dr. Terri Woodard, who specializes in fertility preservation in cancer patients. She explained my options and told me what kinds of things I needed to think about before starting treatment.

I decided to freeze my eggs. This was a complicated choice, because my cancer had tested 100% estrogen receptor positive. That meant the same fertility drugs used to boost my egg production for harvest could also make the cancer grow. I already had suspicious spots on my liver and lungs, and Dr. Kimberly Koenig, my oncologist, didn’t know yet if they were metastases because they were too small to biopsy. So, she wanted me to begin chemotherapy right away.

I wasn’t sure if I’d be able to work, do IRONMAN, or even have a partner, much less children. So, freezing my eggs helped me feel like I could preserve just one thing. I started fertility treatments on Dec. 16, 2016, and froze my eggs on Jan. 3, 2017. That same afternoon, I got a Lupron shot to shut down my ovaries. Three days later, I started chemotherapy.

Step 2: Preserving my lifestyle during breast cancer treatment

Chemotherapy was hard, but it was important to me to stay active while I was receiving it. So, I exercised and worked all through my treatments. That helped me stay positive.

I finished chemotherapy on May 18, 2017. The next step was surgery. My surgical oncologist, Dr. Dalliah Black, and my plastic surgeon, Dr. Rene Largo, recommended a mastectomy to remove the tumor along with my left breast, followed by radiation therapy under Dr. Welela Tereffe and a preventive mastectomy of my right breast. I had the mastectomy on my left breast on June 9, 2017, and the preventive mastectomy on my right breast on Dec. 4, 2017.

I cannot begin to tell you how fantastic these physicians are. Dr. Black was able to spare my own skin during the first mastectomy, even though the tumor was only one millimeter away from it. That meant I wouldn’t need a skin graft from someplace else. She also worked closely with Dr. Tereffe to determine that I only needed a sentinel node biopsy and not a full axillary dissection. That reduced my risk of lymphedema.

Deciding when to have reconstructive surgery was tricky. It was really important to me to get back to training as quickly as possible. But Dr. Largo does ultramarathons, so he totally understood. He recommended postponing getting tissue expanders until after I’d completed radiation therapy. That way, I could still run comfortably while training.

These are just a few examples of great doctoring. My doctors were able to make good recommendations because each of them took them time to get to know me and learn about what I do in my spare time.

Step 3: Finishing strong after breast cancer treatment

Before cancer, I was a globally ranked IRONMAN triathlete, and narrowly missed qualifying for KONA — the IRONMAN world championship — several times. I really wanted to compete again after treatment, but I didn’t know if it would be possible. I didn’t have full range of motion in one arm, and it was very painful to swim, run and bike.

I knew I had to keep trying and doing rehab, so I started training again in April 2018. And on April 27, 2019, I participated in an IRONMAN competition in The Woodlands, Texas. It was my first competition of any kind since finishing treatment, and I achieved my fastest time ever. That qualified me to compete at KONA, and my husband — whom I met while going through chemotherapy — was there to cheer me on. So, I don’t think there will ever be a sweeter finish.

Side effects from my treatment still affect me every single day. But that doesn’t mean I can’t do what I want. Even when we struggle, we can overcome.

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