The Light at the End of the Tunnel

For the last year, I’ve had an especially difficult time imagining a future for myself. Whether I want to admit it or not I associate cancer with death. My mom passed away from Leukemia in 2006 at 42 years old and a few years earlier her sister passed away from Ovarian cancer. Cancer runs rampant throughout my family. From a young age, I felt I was destined to get it as well. I couldn’t imagine a life for myself without my Mom in it and fell into a deep depression a few years after she passed. I remember hating God and wishing that I would die so that I could be with her again. This went on throughout my teenage years. With the help of therapy, I managed to find my purpose and pursue a career in social work. I found my passion and also my will to live. I looked deep within and realized that I could take my pain and turn it into purpose. I graduated with my Master’s at 24 years old, passed my licensing exam, and was ready to finally achieve my goal of becoming a therapist. Then, less than a year after graduating, I found a very large lump in my left breast one night while I was in the shower. I can still feel that sinking feeling in my heart the moment I found it.

In January 2022, I received a call from my breast surgeon that my biopsy came back malignant. My 5.5 cm tumor was stage 3 grade 3 triple negative invasive ductal carcinoma. For weeks I kept thinking, “There must have been a mistake. They’re going to call back and tell me they accidentally gave me the wrong results. Can 24-year-olds even get breast cancer?”. Denial is real. After so many doctor’s appointments, I couldn’t deny it any longer. My oncologist informed me that I had the most aggressive form of breast cancer and that they were recommending 12 rounds of weekly Taxol and Carboplatin infusions and after that 4 rounds of Adriamycin and Cytoxan. Looking back on it now, sometimes it doesn’t even feel real.

Being that my cancer was extremely fast-growing, I had to start chemotherapy right away. So much was happening so fast that I didn’t feel like I had time to process the meaning of everything emotionally. I found out that chemotherapy would most likely take away my ability to have children and also that fertility preservation is not covered by insurance. I found out that it would cost $10,000 to do the fertility preservation and then around $1,000 annually to store my eggs. Fertility preservation is when you go to the doctor’s office every morning around 6 AM and they inject you with a medication that encourages your body to produce more eggs. If I remember correctly, this part of the process takes about 10 days of daily injections and then they surgically remove your eggs to store them for future fertilization. Within a month, I went from being a normal 24-year-old focused on my career, boyfriend, and hanging out with friends to making huge life-changing decisions about my health, future, and overall mortality. Since the cancer was growing so fast, I decided to start chemotherapy right away instead of moving forward with fertility preservation. My rationale was that if my cancer spreads to other organs then I really wouldn’t be able to have children.

Within two months of my diagnosis, I had lost my hair, had multiple scans and biopsies, and had my port placed. I would get chemotherapy infusions every Friday and continued working Monday through Thursday. I ordered a couple of wigs and hated them. They’re so hot and itchy. I rocked the bald head. I remember feeling so self-conscious going to the store because I could feel people looking at me. I don’t blame them, I’d probably do the same if I saw a young person walking around bald. I stopped looking at myself in the mirror for months. I didn’t recognize the person I was seeing. As much as I tried to grip onto my past identity, I knew at a certain point I would have to let go of her. She wasn’t there anymore.

In May, I had my second dose of the most toxic chemo drug out there. I became severely neutropenic. Being neutropenic means that your immune system is compromised and there is an increased susceptibility to infection. I also had very low levels of hemoglobin which made it difficult for me to breathe. I would walk up a flight of stairs and have to lean over the kitchen counter to catch my breath. I had blood transfusions but still felt like shit. On top of that, my heart rate would be around 160 just from walking up the stairs.

One night I woke up and my clothes were drenched. I took my temperature and my fever was 100.1. I felt a little worried but because I had never been neutropenic before I didn’t realize how serious this was and I went to lay back in bed. A few hours later, I thought I was going to die. I asked my boyfriend to take me to the ER. There were probably about twenty people sitting and waiting in the ER intake area. As soon as I told the screener what the situation was, a nurse took my blood pressure and within seconds they were rushing me off to the trauma bay in a wheelchair. My heart rate was in the 170s. Looking back on it now, I realize how serious the situation was. They took off my clothes, started an IV, hooked me up to an EKG, took X-rays, took a CT scan, and then found that I had appendicitis. The doctor asked me to sign a consent form and said they could do my surgery within the hour. I was shocked. I had always heard that appendicitis was painful so I almost couldn’t believe that it was true because I didn’t have any abdominal pain. I had my appendix removed and spent a few days in the hospital on strong antibiotics before being discharged.

I stopped working in June because it finally became too much; especially after my hospitalization. My body felt so weak and sick. I could barely get out of bed and was exhausted all of the time. This exhaustion is the type that is not remedied by sleep. It feels like every single cell in your body is struggling to survive. I guess that’s what happens when you poison your body with chemotherapy. In July, I had my last chemotherapy and scheduled my lumpectomy surgery for August. This was a time of celebration for me. I felt like I could see the light at the end of the tunnel. I kept telling myself that I got through the hard part and just had surgery and radiation ahead of me. I was anticipating finishing treatment around October. After my lumpectomy, I received the pathology results that showed there were still some residual cancer cells that were active within the tumor but that most of it was dead tissue. I also was told that my lymph nodes came back negative for cancer. This was great news, even though my tumor wasn’t completely dead it still shrunk and my lymph nodes were negative. For the first time in a while, I was feeling hopeful for the future.

In September, I found out that there was a suspicious mass on my CT scan. I had an MRI-guided core needle biopsy and during that biopsy, they found a new suspicious spot. It turns out the original spot they found on the CT scan was not cancer, but the new one that they decided to biopsy that day on the spot was HER2+ invasive ductal carcinoma. To say I was disappointed is an understatement. I don’t think words can describe the soul-crushing feeling that I felt. I had done everything I was supposed to and yet the cancer still found a way to return. My breast surgeon recommended a mastectomy and my oncologist recommended a combination of two targeted drugs called Herceptin and Perjeta. I did both. I had my double mastectomy in November and decided to do reconstruction with tissue expanders. Since I would need radiation, I couldn’t get implants right away. They put these empty placeholders that they fill slowly to stretch the skin over time. They sew them to your rib cage. I also had both nipples removed as they posed a risk for an area of recurrence. In the weeks leading up to my double mastectomy, I was feeling like I wanted to give up. I was in a dark place mentally and spiritually. I felt like the universe just kept sending me messages that I’m not supposed to be here; that cancer would take me too just like it took my Mom. Part of me even wished it would. I was so exhausted to my core but I just kept going.

I healed well from my surgery and was feeling a burst of energy and motivation to take back control of my life. Cancer had taken so much from me but I wasn’t going to let it do that anymore. I was fired from my job in December due to being on short-term disability for too long. They said that they could no longer hold my position. I felt like this was a sign for me to do what I was called to do. I became a clinician in the first place I ever went to therapy as a teenager. I felt like this was a full-circle moment for me and was so excited to have a fresh start. I started my new job in January 2023 and shortly after began my daily radiation sessions. Although I was tired from all of the treatment I had been through and from waking up at 6 AM every day to go to radiation before work, I had this energy deep within me to keep going. I felt so fulfilled being able to guide others through their hardships. I loved my colleagues and work environment and was feeling so grateful to have a second chance at remission.

At the end of February, I found out that my cancer was back again. HER2+ invasive ductal carcinoma. It was in the same spot as my last tumor and sat just above the tissue expander on my chest. My doctor explained to me that the cancer in my body is now Stage 4 as there are tumor cells circulating throughout my blood and as evidenced by the cancer cells spreading to my skin. Again, I find myself having difficulty accepting that I’m considered stage 4. The cancer hasn’t spread to my brain, bones, or any other distant organs so part of me feels like I don’t want to believe that it’s stage 4. Stage 4 is the kind that people refer to as “terminal”. Again, I found myself being unable to see the light at the end of the tunnel. Now it really felt like there is no end in sight. Throughout my entire cancer experience, I always felt like death was lurking in the corner. It felt like something I couldn’t escape or control which brought up feelings of anxiety like I’ve never felt before. I felt like every day I was waking up and looking my fading mortality in the face. I felt like I had lost my power. I felt like cancer was winning and I was losing. After leaving my job to focus on my health, I’ve done a lot of work around this. I started thinking “How can I heal? How can I turn my weakness into my power and regain control?”.

During the last couple of months, I’ve been reflecting a lot on the idea of control. We have been conditioned to believe that we have control over things around us, but the truth is that we have absolutely no control over things that happen outside of us. At first, this realization can bring up a lot of feelings of fear. However, I believe that we can transform this fear into power. There is freedom in the fact that we cannot control what happens around us. Release and surrender can be so freeing. This is not to say that we should give up. In fact, I’m suggesting the opposite. Let’s take the energy that we put into trying so hard to control things that are out of our control and put them to good use. Do you know what we can control? Our inner reality, our perceptions, our actions, our choices, our beliefs, our feelings, how we take care of ourselves, the boundaries we set, how we talk to ourselves, our priorities, the people we surround ourselves with, and the list goes on and on. This is not to say that we should only have “positive” emotions or “good vibes only”. Sometimes healing is messy and that is an important part of the process. We need to experience the full range of emotions to grow and heal. Without sadness and loss, we wouldn’t be able to feel joy and gratitude. The goal is to reach a place of balance where we can allow ourselves to experience the full spectrum of human experience.

Lately, I’ve realized that it’s not about the past or the future, but what we do with the present that means everything. Our thoughts about the past and future are our perceptions and nothing more; it’s not tangible. However, we have the power to create our own reality now through the things that I listed above. We can catch ourselves engaging in unhealthy behaviors that are aligned with our idea of our past selves and make changes that our present and hopefully future selves will thank us for. There is so much power in the present moment. I am taking back my power by creating my own reality where regardless of my stage 4 cancer diagnosis, I am someone who loves deeply, helps heal, feels joy, and most important of all takes care of myself in all of the ways that I need. I am rewriting my story. I am not a victim, I am someone who takes my pain and turns it into purpose. Every morning that we wake up is a new opportunity to rewrite our stories in the way that we want and that in and of itself is a miracle. I am actively choosing to be the light at the end of the tunnel.