How It All Started

My name is Domenica, but everyone calls me Donna. I’m divorced with three children, and I’ve been a sole practitioner attorney for almost 28 years. My sister is my paralegal and my mom helps out doing bookkeeping. I am 100% Sicilian, so working with my family is fun on most days, but I must have fired my sister, or she’s quit, at least 10 times over the last 15 years she’s worked for me.

Whether it’s my Sicilian genes, being a lawyer, or raising my kids, I’ve always been an advocate for everything—except for my health. It took me a long time after my cancer diagnosis to realize that I have to rely on myself, too, and trust my own instincts.

Right before I was first diagnosed with breast cancer, I was going through a rough time. The economy had really hit a low point; my business was taking a hit and I was going through a contested divorce. In March 2010, the court gave me possession of the house and temporary custody of the kids. My sister and nieces traveled a long way to be with me for that hearing and we all planned on going back to my house for the evening. My husband decided that night that he was not going to leave the house until he had a written court order, so my family and I decided to get hotel rooms instead.

My now ex-husband's decision to be a jerk that night saved my life. My family and kids went to the pool to hang out, but I went to relax in the room. I was always in a hurry, waking up early, running through a shower, barely making it out the door on time. So that night I decided to take a bath—something I had not done in years. While I was washing, I felt something hard, like a frozen pea, under my left arm. As soon as I touched it, I got this weird, sinking feeling in my heart—that feeling you get when you break up with someone you love. I got out of the tub, grabbed a towel, and sat on the edge of the bed. Even though I had no family history of breast cancer, that’s immediately what I thought of.

Facing Diagnosis As A Single Mom

The next day I made an appointment with my OB-GYN. He did an exam and told me, “You’re young—46 years old. It’s probably nothing.” I didn’t trust my own instincts, so I waited three more weeks to go get a mammogram because of what he said to me.

I got a mammogram, an ultrasound on my left arm, and a biopsy. Then, on April 2, 2010, Good Friday, the nurse called and told me the biopsy showed I had Stage III breast cancer. I was stunned. It didn’t seem possible, even though in my heart I’d known it was something bad. I called everyone to the house: my oldest son, who was 20 years old; my two youngest kids—who were 10 and 13 at the time; and my mom and sister. I didn’t know what was going to happen to me, so I just brought them together and said it: “I have breast cancer.” And even though I was scared, I really believed it was going to be all right.

My youngest kids didn’t ask questions, and I didn’t want to tell them too much; I didn’t want to scare them. I didn’t want to tell my mom too much, either, because she was older and I didn’t want her to worry. But my oldest son was devastated. He is my first born and attached at my hip. That Monday, I went to see the surgeon, and my son, my mom, and my best friend came with me. Dr. Doom-and-Gloom, as I affectionately call him, told us that I had an aggressive form of breast cancer and that I would need to see an oncologist and start treatment immediately.

I have learned that you need to deal with cancer the way you want. If laughing makes you feel better, do it. If you want to cry, cry! If you want to scream, scream! If work takes your mind off of “it,” work. Do what you need to do to take care of yourself and your family. That’s what I did. After six months of chemo, my tumors shrunk and Dr. Doom-and-Gloom suggested a mastectomy to get rid of the remaining cancer. Even though he thought the cancer was just in my left breast, I was all for getting both removed because I wanted the cancer gone! After surgery, he said, “I removed 20 cancerous lymph nodes from your left arm and found breast cancer in your right breast.” This is when I learned something that I truly wish I’d known much sooner. I have been getting mammograms since I was 40, but I have dense breasts, so I should have been getting ultrasounds or MRIs, too. And yet, for the last six years, I hadn’t even been reading my mammogram results. I’d just put the letter away because I thought that if there was something wrong, the doctor would tell me.

I had and still have a lot of “what ifs” about that, but there was good news! The cancer had not gone past my chest wall. Great, time to move on! Of course it wouldn’t be that easy. I asked Dr. Doom-and-Gloom what all this meant (wrong question), and it meant that I would need aggressive radiation. Okay, no more jokes: my daughter was 10 years old, my sons 13 and 20! I couldn’t be a burden. I had to be there for them.

Navigating Next Steps

I left the doctor’s office and just lost it—went absolutely mental! I called my oncologist and she got me in the next day. She said, “You could die on Interstate 4 tomorrow; you are not a statistic! We will get through this.” That made me feel better. I got the radiation and on December 30, 2010, my treatments ended with no evidence of the disease eight months after my initial diagnosis.

This is when the anxiety really began for me. I was going to work and taking care of my kids—and I felt fine—but I’m used to fighting. Here I was doing nothing to treat my cancer. I thought about my cancer coming back every day. The unknowns stressed me. I started doing research and joined support groups online. Talking to others helped, but the whole thing with cancer is that it’s out of your hands. So you have to take more control when you can and be proactive with your doctors.

So when my oncologist stopped doing PET scans, saying that my tumor markers were good, I thought: Really? We aren't going to do regular PET scans at least once a year? I don't think so. I wanted to know what was going on with my body, so I found another oncologist for a second opinion. He trusted my instincts. I asked for a PET scan because it was coming up on five years since I stopped treatment. He tried to get one, but it was denied by my insurance because it wasn’t a “necessary” procedure. They approved a CAT scan instead, which ended up showing some activity in the lymph nodes by my kidneys—talk about trusting your own instincts. Of course, the PET scan got approved then. One biopsy later, they discovered the cancer was now metastatic.

I was devastated—and so was my family. The word cancer is scary, but knowing that you’re at Stage IV, that’s tough. But honestly, I was expecting “it” to come back. At least now, I’d started self-advocating. I truly feel getting a second opinion saved my life, but my original oncologist was an expert in breast cancer and we had a great, honest relationship. So I went back to her to discuss my options.

My doctor told me I needed to begin treatment right away—I wanted to talk to her about IBRANCE. We talked about how IBRANCE along with letrozole, which is an aromatase inhibitor, is for first-line treatment of postmenopausal women with HR+/HER2- metastatic breast cancer, and I further discussed possible benefits and risks with my pharmacists.

My oncologist and I agreed I’d take it.

I got the helpful Pfizer Co-Pay card for financial assistance to patients who are eligible, commercially insured, and need help with their co-pay and I took IBRANCE along with letrozole, as prescribed. I knew it was important to take my medication around the same time, so I picked 12:30 because the one thing that is important to lawyers is lunch, and nothing is usually scheduled then. I had an alarm set on my phone and, no matter what I was doing, my sister brought me food and told me to take my pills. If for some reason I was in the middle of talking to a client at that hour, I just told them I had a medication to take that needed to be taken with food. It was weird sometimes, but necessary. And my oncologist and I were happy with my results on IBRANCE for a while. I did experience some side effects, including nausea and fatigue. Those were my experiences, and yours could be different. Other patients may experience side effects including low white blood cell counts or infections.

I spoke with the specialty pharmacy to make sure none of my other medications interfered with IBRANCE, and I had PET scans and bloodwork every month. I always came prepared to ask my healthcare team any questions, and they knew it was important to me to know my test results right away. My sister, mom, son, or best friend came with me to the appointments. I think it’s important to have someone for support and to help you remember things. I stopped taking IBRANCE with letrozole in November 2016 and am now receiving a different treatment.

Keeping My Priorities Straight

Yes, it can be hard asking for help, but sometimes you have to. You may be a mom, sister, aunt, and daughter, but you deserve to have time for yourself. Don’t feel guilty. People are very accommodating and understanding and I have had experiences I would not have had if I hadn't been diagnosed with breast cancer. Judges, lawyers, and people I work with raised money so I could take my kids to Italy, including Sicily. And, my oldest son and a local radio station made another dream come true—having my very own flash mob. I don't know how they kept it a secret, but there were about 60 or more people there dancing to give me hope.

Breast cancer has changed me and my children. We say “I love you” more often, we hug more often, and we spend more time together. The counselor told them I am allowed to use the “cancer card” when they get me mad (joking). I try not to sweat the small stuff. When I do, I have a punching bag in my office to deal with it.

I’m thankful to be here to have seen my son graduate high school, to see my daughter with her first boyfriend, to be able to threaten his life if he hurts her. I appreciate that I’m alive and getting treatment that right now is working for me. I only wish it hadn’t taken me so long to become my own healthcare advocate. So, the one thing I want to tell you is to follow your instincts. Don't let anyone tell you that you cannot have a PET scan or a blood test or anything you feel you need. Fight for yourself, and remember you are not a statistic!