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“HR+/HER2- mBC may be the path we’re on, but it doesn’t have to lead to hopelessness.”

A Family-Focused Wife And Mom As Well As An Accomplished Civil Engineer

ABOUT NORMA, IN HER OWN WORDS:

• I have always been a person following a nontraditional path in a traditional world.
• Fourteen years after I’d thought I was done with breast cancer, all the fear came back with an HR+/HER2- mBC diagnosis.
• None of us know what our future is—no matter what we’re dealing with, the best we can do, I think, is try to look for new adventures.

Looks May Be Deceiving

You may not be able to tell by looking at me, but I was a certified corrosion specialist. Now, one of the dictionary definitions of “corrode” is to weaken or destroy gradually, to undermine. As an engineer, I was an expert in the more technical aspects of the word. And, as a person living with mBC, I understand both senses of the word on a deeply personal level. It’s said that everything “corrodes,” be it metals (my specialization), or bodies. But I think there’s one thing that doesn’t have to corrode: the spirit to keep fighting an ongoing disease like mBC. mBC may be the path we’re on, but it doesn’t have to lead to hopelessness.

Making Her Own Way In The World

I have always been a person following a nontraditional path in a traditional world. I learned early to adapt and adjust to what life put in front of me and to not be afraid of blazing new trails.

I’ve spent my whole life in South Dakota—like my mother who lived to be 102—and I grew up in the same community where she and my father lived their whole lives. I am the only girl and the baby of the family, born nine and 11 years after my brothers. Mostly due to the ratio of boys to girls in my life, I became used to being different. My first seven years of school were in a one-room country school where I was the only person in my grade level.

There were three boys in the grade above and two boys in the grade below. Recesses were spent playing football and chasing gophers. Back at home, my brothers taught me not to cry and not to tattle to Mom—even when they put me on the back of a cow and it bucked me off.

When it was time for college, I didn’t want to follow the traditional avenues available to girls back then: teaching, nursing, or secretarial work. My older brother was an engineer, so I decided that’s what I’d be too. Not many women were pursuing a degree in civil engineering. But I liked the discipline of it—and in engineering, as in nature, you learn to adapt and adjust in order to keep moving forward. That “adapt and adjust” attitude has probably served me well on my breast cancer journey.

Adapting And Adjusting To A Diagnosis

After college, I got married and then found a dream job as a field engineer for a natural gas pipeline. I loved it—and over time, I became certified in corrosion control. Part of my job was to do what I could to prevent corrosion, spot areas of weakness, and decide on the approach that might work best for a particular situation.

Unfortunately, the company I worked for experienced business difficulties, and I found myself looking for a job. I found one two blocks from home: teaching construction management at a state university. It was the very last thing I expected to do for a living. But, with time, it seemed to fit my lifestyle, as it provided flexibility for me to spend time with my family. Sometimes we go where our paths lead.

Then, many years later, something felt off. My breasts were puffy and sore, and that night, I felt a lump in my left breast. Rather than get too worried, I waited. My breasts were always lumpy, but this lump felt different; it was kind of gritty. After two weeks, it was still there, and at my husband’s urging, I went to the doctor. He reacted immediately after feeling the lump, and his reaction scared me. Arrangements were then made for a mammogram. After the mammogram came an ultrasound, and then a biopsy was scheduled for the Monday after Christmas.

I dreaded telling my mother what was happening. Her mother, my Grandma Lydia, had died of breast cancer at 64, and six of her siblings had also died of cancer. One of her sisters died of breast cancer at 37.

On the Thursday after Christmas, my results came back positive, and the surgeon had me come in for an appointment right after lunch. I’m certain I didn’t eat lunch that day. During the doctor visit, my husband and I decided it was best to follow the doctor’s recommendation to have a mastectomy. Fortunately, he had an opening the next morning, which happened to be New Year’s Eve. Now it was time to tell my mom. She took it as well as a strong lady from the Greatest Generation with German ancestry would be expected to. I just remember hearing her say, “I’m sorry.”

Handling The Impact All Over Again

My first marriage had ended in divorce, but I’d remarried a fine man, Cliff, who had four boys. With my son and daughter from my first marriage, six kids in the house made for a very lively home. My kids were with their dad when I received my breast cancer diagnosis, so I didn’t tell them until they were with me again after surgery. They both seemed to accept the news well. Amazingly well. It helped that Cliff kept a light spirit and provided his twisted levity to help distract me from moping. His creative humor also, I believe, helped the kids process and accept the situation.

Many years later, I asked my daughter, Morgan, how she felt about it back then. She related I had told her I would be all right, so she believed it would be. I remember saying it to help provide comfort, but I had been shaking in fear inside. Still, as a corrosion specialist, there was a certain satisfaction in knowing that the weakness in my body had been spotted, treated, and stopped.

But it hadn’t been stopped. Fourteen years after I’d thought I was done with breast cancer, all the fear came back. It was fall, and I was making plans to expand my hobbies, enjoy more time with Cliff, and write research papers for fun. I even had that great feeling of relief that things were going well. However, during the summer, something about the lymph nodes in my left armpit felt “off,” and one night, while I was in the shower, I felt a lump. It also seemed like my weight was shifting; my bras were getting tight, even though I wasn’t gaining weight. My back would occasionally be sore as well, but I attributed that to age. Lying in bed, my hands would tingle—another sign of aging that went with my back. It was nothing intense, just there once in a while. My brother talked about similar symptoms, so I thought this was something that ran in the family and that I would need arthritis surgery someday. This time, considering my previous breast cancer experiences, I didn’t wait to see the doctor.

After a biopsy and scans were completed, the surgeon gave me the news that my cancer had returned. I unraveled. I never cry—my brothers had taught me not to. But this stage IV diagnosis was much worse than my initial breast cancer diagnosis. I cried. And cried. And cried. I was crying so much that they eventually tucked me into an exam room until they got me all the information I needed and I could go home.

It was again time to tell Mom. This time was harder, as Mom, who was living alone, had now become dependent on my help. She was stoic afterwards, and she no longer confided in me the same way. I know she was trying to protect me; she didn’t want me to worry about her and take care of her when I had my own medical problems. I couldn’t help feeling like I was letting her down. Emotionally, it was very difficult. My mother is a very private person, and she wasn’t as comfortable telling my brothers about her health or asking them for anything. Who would take care of her if I couldn’t?

Getting Underway With Treatment For HR+/HER2- mBC

The time between receiving the PET scan results and the oncologist appointment was emotionally exhausting. I felt like a basket case and prepared for the worst, but a visit with my oncologist helped to ease my anxiety. We have a great doctor-patient relationship. He listens to me even when I worry about small pains that end up being nothing. When we first started discussing treatment options, he told me about a treatment indicated for adult patients with HR+/HER2- advanced or metastatic breast cancer. He seemed knowledgeable and comfortable with that treatment plan: IBRANCE and letrozole, which is an aromatase inhibitor.

He went over how IBRANCE worked and was very clear and concise about it. He had the pharmacist come in to talk with me so we could make sure all my medications and vitamin supplements were compatible. The pharmacist gave me a welcome packet, and we went over the potential benefits and risks, including the serious and common side effects of IBRANCE. He also suggested I call Pfizer Oncology Together to find out about financial assistance resources. Everyone’s situation is different, but I was able to enroll in a co-pay program for eligible commercially insured patients, which was nice…one less thing to think about. Now, I am mostly retired, and Pfizer Oncology Together is still helping with the financial expense of IBRANCE. I formally retired from teaching but was asked to come back to pick up a few classes, which I will continue as long as the opportunity is available. It’s been a nice transition into retirement, as it provides time to make plans for retirement adventures.

Learning about the medication gave me peace of mind. The term “inhibitors” was a familiar one: In corrosion engineering, inhibitors are chemical compounds put in metal holding tanks to treat the liquid and make the environment less corrosive. They help slow the deterioration rate. Now, medicine obviously isn’t metallurgy, but it felt good to understand the theory behind a treatment. I have experienced side effects, including low white blood cell counts, which my doctor continues to monitor. Of course, this is just my experience, and everyone’s experience may differ. Others may experience other serious or common side effects, including lung problems or infections.

Please see Important Safety Information here.

Embracing Gratitude

But, just as a coat of paint is another barrier to corrosion, there are other things I do to support my health. I enjoy walking and working outside in nice weather. It gives me time to think, relax, and meditate, and I also find peace by doing yoga, lifting, and cardio. About six months after starting IBRANCE, Mom began telling me what she needs and letting me help her again. This is just my experience, and others may have a different experience.

My doctor told me this diagnosis doesn’t have to define me. Many times, those simple words have helped me realize that I am still the same person. In corrosion, there are “sacrificial anodes,” highly active metals that are used with a less reactive metal that’s in danger of corroding. They sacrifice themselves to protect a structure. But I don’t have to sacrifice my sense of self in order to fight mBC, to fight for hope. There have been other challenges in life which needed to be faced head-on. My parents had the courage to get through the Depression and World War II. I have also had to find inner courage to overcome life’s challenges, and I find comfort in knowing that there is a higher power watching over me. That has been a blessing many times.

None of us know what our future is—no matter what we’re dealing with. The best we can do, I believe, is to stay strong and look for new adventures. Today, I am grateful for the ongoing medical advances in metastatic breast cancer treatment. I am grateful that I was able to take care of my mother. I am grateful for life’s moments.

_{Ambassadors were asked to share their personal stories about IBRANCE and compensated by Pfizer for doing so. All content was accurate at the time of publication and is assessed periodically for accuracy.}

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