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Cancer fight yields lessons

October is National Breast Cancer Awareness month

Charis Weis, a breast cancer survivor, and Melodi Johnson, nurse navigator at the Breast Health Center of Mid-Columbia Medical Center, show off a T-shirt designed by Weis and local artist Jim Semlor to raise public awareness about how early detection of cancer can save lives.

Photo by RaeLynn Ricarte
Charis Weis, a breast cancer survivor, and Melodi Johnson, nurse navigator at the Breast Health Center of Mid-Columbia Medical Center, show off a T-shirt designed by Weis and local artist Jim Semlor to raise public awareness about how early detection of cancer can save lives.



Breast cancer in young women is rare but can often be more aggressive, according to the Young Survival Coalition (YSC).

More than 250,000 women now living in the U.S. were diagnosed with cancer under age 40. They have a higher mortality rate and are at greater risk of the cancer returning in areas beyond the breast.

Here are some statistics provided by YSC about how breast cancer is different in younger women:

• There is no effective screening tool for women under 40, most of whom have dense breast tissue that prevents routine mammograms from being effective.

• Every year, more than 1,000 women under age 40 die from breast cancer.

• Nearly 80 percent of young women diagnosed with breast cancer find a lump or abnormality themselves.

• Breast cancer is the most common form of cancer in women who are pregnant or have recently given birth, occurring once in every 3,000 pregnancies. An estimated 30 percent or more of all breast cancer in young women is diagnosed in the few years after a woman has had a baby.

• Compared to older women, young women generally face more aggressive cancers and lower survival rates. More and more evidence points to breast cancer before age 40 being biologically different from the cancer faced by older women.

Charis Weis was grappling with her mother’s breast cancer in October 2017 when she felt a lump in her left breast while showering.

“It was small, pea-sized, but I thought it was odd,” she said.

At age 35, Weis had not yet even started having mammograms, which are recommended for women 40 and older unless there is a family history of cancer.

Her mother had been diagnosed three months earlier and Weis felt remorse that she had not checked to see if her mom was getting regular mammograms and doing self-exams.

“It hit me like a ton of bricks that we need to have more conversations like this,” said Weis, who worked with local artist Jim Semlor to design a T-shirt that encourages dialogue.

“We really wanted to bring home that image,” she said.

Little did Weis know that she would soon be fighting her own cancer battle.

She was initially told by her physician in Goldendale, where she lives, that the lump needed to be watched but did not have the markers of a cancerous tumor. However, it had grown enough by December that she knew something was wrong.

“It scares me to think that I was told it was okay and I think most people would have backed off,” Weis said. “I really encourage women to listen to their body.”

After her second doctor visit, arrangements were made for Weis to have a biopsy that yielded bad news.

While her mother’s tumor had been confined to a duct in the breast, requiring only a lumpectomy for treatment, Weis was diagnosed with “triple negative” cancer, which tends to spread beyond the breast.

Triple negative type was given that name because of the absence of estrogen, progesterone or HER2 receptors, which are found in most breast cancer. This cancer is much more aggressive and does not respond to normal treatment, such as radiation and Tamoxifen, a drug that blocks the actions of estrogen, a female hormone.

Can motherhood help prevent breast cancer?

According to the some studies, pregnancy and breast-feeding can reduce the risk of breast cancer.

In fact, women who’ve carried at least one pregnancy to term are less likely to get this type of cancer, especially if they bore a child before the age of 30.

How it works

When a woman is pregnant, her mammary cells are no longer exposed to estrogen, a hormone that promotes the development of several breast cancers.

The same thing happens during breast-feeding.

In fact, some studies indicate that breast-feeding can protect you from getting breast cancer, and that the longer you breast-feed, the greater the protective effect.

Breast-feeding

Are you undergoing treatment for breast cancer and fear that breast-feeding might harm your baby?

While cancer cells definitely can’t be passed on through breast milk, chemotherapy drugs and other medications can. This is why breast-feeding is usually not recommended for mothers with cancer.

But for advice that’s specific to your case, speak with your doctor.

Fertility

Treatment may also affect fertility. A woman needs an adequate number of healthy eggs in her ovaries to get pregnant naturally.

These eggs are all made before she’s born and spontaneously die with age; however, invasive drugs and forms of treatment can damage and kill eggs prematurely (e.g. chemotherapy) or delay pregnancy, giving eggs time to age naturally (e.g. hormone therapy).

If you’re a young woman recently diagnosed with breast cancer, your doctor may recommend the following courses of action:

• In vitro fertilization (IVF). Colloquially referred to as the “test tube baby” technique, IVF stimulates the growth of eggs, collects them and fertilizes them in a test tube to create embryos, which are later implanted in the woman’s uterus.

• Frozen embryo transfer (FET). FET is a cyclical treatment that involves thawing frozen embryos from previous IVF cycles (or a donor) and transferring them back into the woman’s uterus. FET is considered the most effective fertility preservation strategy; however, women who are single or not yet married may feel more comfortable freezing eggs that haven’t yet been fertilized.

About 15 percent of all breast cancer detected in women is triple negative, according to the American Cancer Society.

The key to treating this type of cancer is to have the patient undergo chemotherapy first to shrink the tumor, followed by surgery.

Because of her young age and the aggressiveness of her cancer, Weis decided to have a double mastectomy and undergo immediate reconstructive surgery.

She is the mother of two, a 20-year-old son in the Air Force and a 16-year-old daughter, and the heart-wrenching possibility of not being there for them drove her to fight for recovery. “That was the hardest part,” she said. “They were really my motivation to fight. And, while I was doing that, I still had to be mom for my daughter, who is home. I had to keep everything as normal as possible.”

Before surgery, Weis underwent five months of chemo at Celilo Cancer Center in The Dalles that caused her hair, eyelashes and eyebrows to fall out.

Although she was offered a wig through a special program at Celilo, she decided to just brave a bald head, which brought a surprising but welcome realization.

“People were extremely kind,” she said. “I looked sick even though I felt fine after the first eight weeks of chemo (drugs were adjusted) so people were always getting me shopping carts and helping me out.”

Weis already knew Melodi Johnson, nurse navigator at the Breast Health Center of Mid-Columbia Medical Center, because she had worked in the pharmacy and then the human resources department for nine years.

Weis now holds the position of director of human resources at Kilckitat Valley Hospital in Golendale.

“Melodi was the first person I met with and she cried with me,” said Weis of the high level of comfort offered at Celilo.

“The coordination among the people and services in this place is unbelievable,” she said. “I really feel that’s what make this place so special; they cover every base and I felt my questions were answered before I even asked them.”

Weis said chemo sessions at Celilo were very comfortable because many other women were also sporting bald heads and they shared a common enemy.

She met Kaila Garwood, 29, who was also fighting cancer and they became good friends by lifting each other up during the ordeal.

“She is such a beautiful person and it was joyful to be around her,” said Weis.

As a patient, Weis was offered facials and taught about skin care changes by Annette Scott and helped to “look good, feel better” by Victoria Kelly, who focused on body image.

Social worker Pam Barry checked in with Weis regularly via email, phone and in person to be sure she was coping with the emotional and mental toll of treatment and surgery, as well as the physical effects.

“When you are here, you feel normal,” said Weis of Celilo, where her interview with a reporter took place.

She said family and friends surrounded her with support during chemo, which made it easier to stay upbeat about the nightmare playing out in her life.

“I have never experienced such love, kindness and generosity in all my life— and that alone is life changing,” she said.

In June, Weis went through surgery in Hood River and she said recovery has gone very well. In physical therapy, she worked to regain movement of her shoulders and arms, so she could perform daily activities, such as dressing, bathing and combing her hair.

Unlike many of her 30-something peers, who have never experienced a major health problem, Weis said she has learned to take nothing for granted.

“Live to the fullest — it might sound cliché but it’s true,” she said.

Weis tells her friends, most of them also busy mothers, that they must pay attention to their health and seek medical attention immediately if they notice anything that seems off.

“I think that’s hard because we have so many responsibilities as moms – but, don’t wait!” she said.

Every three months, Weis has a checkup to be sure she is still cancer-free. Otherwise, she lives every day with a strong sense of gratitude.

What message does she want other women fighting breast cancer to hear?

“You just have to remind yourself every day that you’ll get through it, that it’s not going to last forever,” she said.



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