Our individual stories from sisters with Stage IV and Metastatic breast cancer

Lisa Winkler (shown here with her mother)

Many people have the misconception that breast cancer only happens when a woman gets older. My name is Lisa Winkler, I'm 37 and I want to share my personal journey dealing with breast cancer.
 
My journey began in March of 2003.  I haven't done self-breast exams in the past but I was in the shower one morning and thought it was time I started. It was then that I felt the strange lump in my left breast. I wasn't overly concerned since cysts ran in my family, so I just kept an eye on it thinking it would go away.
 
By the end of March, the lump was still there, so I brought it to my gynecologist's attention. She agreed that it was most likely a cyst but I should get it checked out to be safe. I was told that 80% of lumps are benign and breast cancer at my age was rare. I scheduled my first mammogram and ultrasound for a month later. I was under the impression that it was no big deal, so why hurry.
 
The mammogram confirmed that it was a mass and the ultrasound confirmed it wasn't a cyst, so a biopsy was done the very next day. All the while, I was constantly reassured that 80% of solid masses turn out to be non-cancerous.   
 
On Tuesday, April 29th, I got the message to call my gynecologist's office; the biopsy results were in. When I called them back, I heard those dreaded words "the doctor would like to see you and your husband in her office today". That sentence alone told me the results without having to hear them and my life came to a screeching halt. I was just diagnosed with breast cancer, and I was only 33.
 
My husband, George, and I left work immediately and went to see my doctor. She discussed the options ahead of me, none of which I ever saw myself doing until this particular moment - surgery, chemotherapy and radiation. She knew a good surgeon and scheduled an appointment for me to see him the following week. She had a good feeling that my cancer was caught early enough but we wouldn't know for sure until after the surgery.
 
I was numb when we left her office and I felt like I was in a bad medical nightmare. Then came the hardest part - how to tell my family. I started repeating what my doctor told me, even though I didn't understand myself yet. And, though I told everyone that I should be just fine, I was wondering who I was trying to convince more at the point, them or me. I think everyone, including myself, was stunned and it didn't sink in right away. Up until now, just hearing the word CANCER gave me chills, now I was the one fighting it.
 
When I got home that afternoon, I tried to regroup and decided that my best course of action was to find out just what I was up against. The Internet had a wealth of information on breast cancer, which I found to be helpful. Once I understood the basics of cancer, the better I felt about my chances.
 
Here's how cancer happens. Normal cells in the breast grow and divide in cycles and new cells are created to replace dying cells to keep the body healthy. Cancer occurs when cells begin to malfunction and cycle out of control. A healthy immune system can target these cells and effectively eliminate them. BUT - a compromised immune system, either sick, or stressed has a harder time doing so. And since these cancer cells live longer than normal cells so they keep building up forming a tumor or travel throughout the body through the bloodstream.
 
At the surgeon office the following week, we learned more about the biopsy results. I had Invasive Ductal Carcinoma. This type of cancer originates in the milk duct but extends beyond it to surrounding breast tissue. When that happens, the lymph nodes closest to the tumor become the next line of defense. Their job is to capture the cancer cells before they travel to other parts of the body. There are actually 10 different types of breast cancer and Ductal Carcinoma accounts for about 80% of all breast cancers.
 
Due the location of the tumor, I was able to have just a lumpectomy. This is the most common surgery for beast cancer where only the tumor and a small amount of surrounding normal tissue, called a margin, is removed. Since the cancer had spread beyond the tumor site, the lymph nodes closest to the tumor  were also removed to hopefully stop the spread of cancer. Since this type of surgery had become so routine, it only took 1.5 hours and I was home the same day.
 
The tumor, margin, and nodes were then sent to a pathologist who determined the type and grade of the cancer cells and how quickly they were growing. The presence, or absence, of cancer in the nodes was very important. All these factors helped in deciding the stage of my cancer, which in turn determined my diagnosis and the best course of treatment.
 
The pathology report concluded that the tumor was 3.3 cm with a clear margin. A total of 18 nodes were removed and 4 nodes were positive for cancer. It was determined that my cancer was at stage 2B and that I had a very aggressive type of cancer.
 
My surgeon felt pretty sure that all the cancer was removed before it had a chance to spread to the rest of my body. He then referred me to an oncologist who specialized in breast cancer treatment at my local cancer center.
 
At the oncologist's office, we discussed the next phase in my treatment. She recommended 8 aggressive chemotherapy treatments to destroy any loose cancer cells that may have escaped into my bloodstream. Chemotherapy is a cocktail of different drugs with the sole purpose to destroy fast dividing cells. But, cancer cells are not the only cells that grow & divide rapidly, so does hair and blood cells. This is why hair loss, weak immune system, and anemia are common side effects.
 
After chemo was over, I was then referred to my radiologist for 33 days of radiation therapy. Radiation is done to eliminate any stray cancer cells left behind within the breast tissue after surgery and to help prevent recurrence.
 
Here's how radiation works: Radiation is an extremely high-intensity x-ray that cuts through a cell and damages its ability to divide. Since cancer cells only have the capability to duplicate, they die off while healthy cells repair themselves. Each radiation session only lasted a few minutes and all I felt was slight warming sensation in the area while the beam is on. The most common side effect with radiation is similar to a gradual sunburn and a good skin cream is all you need.
 
My last radiation treatment was December 8th and I was done with my treatments, cancer free and now considered to be in remission. For the next 3 years. I was monitored very closely because the highest chance of recurrence is during this time frame. The likelihood of recurrence lessens each year after that and once I reached my 5-year mark, I can be considered "cured".
 
I had blood work every 3 months to keep an eye on my tumor marker which is used to detect possible cancer activity in the body. If cancer is present, it will usually produce a specific protein in the blood that can serve as a "marker" for the cancer and for 3 years, my markers stayed stable.
 
March of this year started out just like any other follow-up with my oncologist. But, while I was there, I mentioned about some back pain I was having. Knowing that breast cancer can spread to the bones, I asked about getting a PET scan which is used to detect cancer cells in the body. I was coming up on my 3 year mark and wanted to make sure that the back pain was nothing more than job related stress. I also had my usual blood work as well. Little did I know at this point that that visit saved my life.
 
I was when I called the Cancer Center the following week to schedule the test, I heard those dreaded words again. My Dr wanted to see me back in her office in 2 weeks. I found out that my tumor marker, started to increase. Good thing I asked about that scan. Now I was getting worried. I had a feeling something was wrong.
 
A few days after the scan, I called the cancer center to find out the results. That's when I heard the words "advanced disease". My life screeched to a halt once more. Breast cancer metastasis can occur in nearly any part of the body, although the most common sites are bone, lung, liver, and brain.  Regardless of where the cancer had spread, it is still breast cancer and is treated as such. My Oncologist also wanted me to have a bone scan done to make sure the cancer didn't spread to my bones. So, where did it spread to and could I still be treated in time?
 
Thursday, March 30th was the moment of truth. That's when we found out the severity of the situation. The PET scan revealed that the cancer didn't form a tumor this time but spread directly to my lymph nodes under my left breast, both arms pits, under my sternum and formed a small spot on my lung. Later we also discovered a 2mm spot on my brain. I was now at the critical stage 4.
 
I told my oncologist that I didn't want to discuss survival percentages; that was something I just didn't want to know. I would rather just concentrate on beating this again. So we focused on the plan of attack - very aggressive chemotherapy once again, only this time surgery was not an option. I stared back on chemo 4 days later.
 
In June, after completing 4 chemo treatments, I had another PET scan to see how well the cancer was affected. To our surprise, it was all gone! There was not sign of cancer anywhere. I was ecstatic! I still had 4 more treatments to do, just to play it safe but it looked like I beat it again.
 
It was now September and I only had 2 more treatments to go. I had another mammogram, bone scan, and PET/CT scan scheduled this month make sure I was still cancer free. If all my scans come back clean again, my last chemo treatment would be at the end of the month and I'd be in remission once again!
 
A few days after the scans, I got a call from the cancer center telling me that my last chemo treatment was delayed until my appt with my oncologist that following week. I had a feeling something was wrong and unfortunately, I was right. My cancer wasn't gone completely as we had hoped 3 months back. Although the chemo managed to eradicate the weaker cancer early on, the tougher cells remained behind, hidden until now. I now had new cancer in a few vertebrae, my right pelvis, my liver, and in a few lymph nodes along my trachea.
 
My new chemo regimen started October 2nd with at least 7 more treatments to go, this time with different drugs and a different strategy. It could be a lot worse, I could be standing here today telling you that my days are numbered and I'm incurable - but that's not the case. There are a lot of drugs out there, and a lot of medical advancements made everyday to eradicate this disease.
 
Having cancer was actually a blessing for me. I realized just how important friends and family are in my life and to never take them for granted. I learned how wonderful life is and that even a "bad" day is better than not being here at all. I started to do more, love more, and most importantly - to live more.
 
I feel that everyone who has been touched by cancer shares a common bond and can relate to each other in a special way. I wanted to create a way to show others that cancer isn't a death sentence anymore, it's treatable, manageable, and most of all - survivable.  This sparked the creation of my own web business called CancerCousins.com where I create humorous and inspirational designs on buttons, magnets, and keychains.
 
Just recently, I got an email from a friend that included this line from Jeremiah 29:11. Jesus said to him "I know the plans I have for you. Plans to prosper you and not to harm you. Plans to give you hope and a future".  This tiny reading put the last 3 years in perspective. It became clear to me now that by having breast cancer, I was chosen to help educate others about it and put a smile on the faces of those dealing with cancer themselves. And so, I committed myself to that very mission as long as I live.
 
As of January 2007, I'm still fighting this dreaded disease. The cancer is still spreading - now it's in my lungs, more spots on the spine, and more spots in the liver. However, I still feel great so I know I can continue fighting this until one of us wins - perferably me. I'm getting switched to Navelbine and then maybe Abraxane. Right now, I feel like I'm playing Chemo-roulette, just trying to find that one lucky drug that can at least slow the progression.
 
My story has no ending yet but but I do know this - I no longer live in fear of my cancer, but embrace it for the opportunities that I have been given. My faith has never been stronger and no matter what the outcome, I learned to live life to its fullest. There are no guarantees in life so don't wait for tomorrow to come, make it the most you can today.

Visit Lisa's online Journal: www.bcjournal.homestead.com and www.CancerCousins.com - a link for anyone who might be interested in humorous and inspirational Buttons, magnets, and keychains that reflect the journey of cancer patients, survivors, supporters, and general cancer awareness (including buttons for TheDarkerSideofPink).