The Cancer Couple
A married couple, one a medical oncologist and the other a social worker share their experience as they navigate cancer after both being diagnosed within 4 months of each other.
The Cancer Couple
Becca's Story
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Welcome back for our first real episode of The Cancer Couple! Becca was diagnosed with node positive breast cancer in October 2025 and Joe (a now retired medical oncologist) with Stage 4 Mantle Cell lymphoma in February 2026.
In this episode Becca tells us about her cancer journey to date (with some medical chiming in from Joe).
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Hi everyone, welcome to I guess what is really the first episode of this podcast that we're calling the Cancer Couple. I don't know what do you think about that title. I I don't I don't love being defined by the Cancer Couple, but kind of is what we are right now. I wanted to call it Are You Effing Kidding Me? But back avoided that one down.
SPEAKER_01I thought it'd be better to maybe call it the Cancer Couple because if people are looking for cancer-related content, they won't know what the other title means or what it pertains to. So I thought I'd go with the more obvious.
SPEAKER_00I guess. Well, I think you'll see why I wanted to name it that. But uh getting ahead of myself, uh, this is Joe.
SPEAKER_01And I'm Becca.
SPEAKER_00And uh and we're gonna kind of just dig into this. So I thought we'd start off. Oh, actually, I need to start off at my wife's request with a a legal disclaimer. So I am a retired oncologist. I'm sharing my personal experience as a cancer patient. Nothing on this podcast constitutes medical advice or creates a physician-patient relationship. Always consult your own medical team for decisions about your care.
SPEAKER_01Thank you very much.
SPEAKER_00Straight from Claude. All right, so that's out of the way. So I thought what we could do is start by just talking about who we are. Um Do you want to talk about how we first met?
SPEAKER_01Um, yeah, we've been married, I think coming up on 28 years this summer. And we're both um from Minnesota, the Midwest, and went to small liberal arts colleges, and but not the same one. And uh one of my good friends from the college I went to ended up getting married to a good friend of Joe's at the college he went to, and I was invited to be a bridesmaid, Joe was invited to be an usher at their wedding, and that's where we met that weekend. And I I had just graduated with my master's degree and from UW Madison, go badgers, and Joe was uh starting a fellowship in Oklahoma at the time.
SPEAKER_00Yeah, so I uh as Becca said, we both uh grew up in in Minnesota. I went to medical school at the University of Minnesota, thought I wanted to be an eye surgeon, and then fell in love with oncology on the way. So I was actually in Oklahoma City, at the University of Oklahoma, uh doing my first year of oncology fellowship when we met. And I thought we were far too geographically challenged, although she was super cute.
SPEAKER_01And then I saw her do the macarena on the dance floor, and this is the part the kids will cringe at if they ever listened.
SPEAKER_00It was fate. So um, so I dragged her down to Oklahoma, and and you really liked it in Oklahoma City.
SPEAKER_01Yep, not really. Uh that was a tough couple of years, kind of fish out of water down there, but it was we made it through those couple of years. We did meet some really nice people and some friends I still have today. But culturally, it was very different from the Midwest and the Twin Cities.
SPEAKER_00So uh so we came back to to Minnesota after I finished my training, and we've been here ever since. So I've um practiced primarily in the Twin Cities area. Uh initially it was in private practice, and then more recently working for a larger health system. Um, we have two kids, uh, both in college. Uh Jaden is at University of Wisconsin River Falls, he'll be graduating uh in December, and then our daughter Abby following a mom's footsteps at University of Wisconsin-Madison, where she's doing research in the same lab you were at, right?
SPEAKER_01Yeah, she's working in the same building where I did my summer job 30 years ago this summer. So kind of a full circle.
SPEAKER_00Yep. And so uh so we're the cancer couple now because we've both been personally hit by cancer. We've kind of, in some sense, been a cancer couple because my job has had an outsized impact on our life just because it's always been so busy, and uh we used to say that you were my mistress because I was actually married to my job.
SPEAKER_01Yes.
SPEAKER_00So so, anyways, um uh uh so that's that's kind of who who we are. Uh, and we have a small white dog named Sammy who is getting up in the up in our years. Um but I thought we would start out by just kind of again going through how we got here by since your diagnosis was first, kind of going through how you ended up with your cancer. So you want to start us off?
SPEAKER_01Yeah. So it was just this last October, the very end of October, that I had gotten diagnosed. I've been home with the kids primarily most of our marriage for a long time, but they were both now at college, and there was a little space in life for thinking about what's next for me, and fortunately I didn't jump into anything major because I had an unexpected cancer diagnosis in October of 25, which has kind of become a full-time job since then. So um, yeah, I had an abnormal my first abnormal mammogram. I've gotten mammograms since I was age 40, never had anything abnormal. This one came back abnormal, and so I had to go back to do um a diagnostic mammogram and an ultrasound and biopsy. And I think when I got the message that it was abnormal, I kind of had a gut feeling this was gonna be cancer. And I don't know if it's partly because I'd never had an abnormal mammogram or if I've lived with Joe for so many years and I constantly hear stories at dinner where he'll say, really healthy person, little bit of shoulder pain, cancer was everywhere. And so I had these horror stories as part of our dinner routine for a long time. So maybe it just felt like, oh, you know, a little bit was coming my way. And I will self-disclaimer, I do have some health anxiety, and so you know, I tend to think everything's cancer, but this time it actually felt like I think this is gonna be something in it more of a real sense rather than an anxiety sense. So I went and uh they did the ultrasound or the diagnostic mammogram, and then they did an ultrasound to get a biopsy in my left breast, and the pathologist came in and looked at it while she was um doing the procedure, and she said she was quite worried that that was gonna be cancer, and she kind of looked at me with sympathetic eyes, which I thought was not a great sign. So um finished that, but we had to wait for the results. And Joe was working in clinic that day, so I walked upstairs to tell him I don't think it's just a false alarm, but she's pretty concerned it's cancer, and I think you were pretty surprised at that, or not.
SPEAKER_00Well, most abnormal mammograms end up being false alarms, and so I wasn't too worried, but usually the ultrasound is the most worrisome test. If they're worried that that's gonna be cancer, then it's usually pretty high likelihood it's gonna be. Um, but everything looked pretty good. You know, the ultrasound and the mammogram thought it was really small, less than a centimeter in size. And so I wasn't too worried at that point. You know, you gotta wait and see what the biopsy shows.
SPEAKER_01Right. And if I'm understanding this right, I don't have or didn't have a lot of calcification showing up in my mammogram, which some people do.
SPEAKER_00Correct.
SPEAKER_01And so that maybe was a little harder to detect what was going on, or am I not quite right?
SPEAKER_00No, that's right. Yeah, I mean, there are a couple different things we look for in mammograms that can be a sign of cancer. One of them is calcifications, and that's little flecks of calcium that show up on the mammogram. Um, now that's not always cancer, some people just have calcifications on the mammogram, but that can be a sign of cells dying off, and they can leave little tombstones. Um, a lot of times that's something called DCIS or non-invasive cancer. But the other thing we look for is just a spot, you know, and I think that's basically what your mammogram showed it, just a it was like a shadow.
SPEAKER_01Right, basically. Yep. So um, and then that was on, I think that was a Thursday maybe that I got that done. And then I knew Friday they were probably gonna call me. So I was running errands at Mall of America, and I was kind of on edge, like I could tell my body was kind of tense, but I also was kind of prepared, like I think they're gonna tell me it's cancer. So it was kind of a weird um holding two things at the same time in my body. But I got the call from the nurse, and she told me that I had invasive ductal carcinoma, and meaning that the cancer is breaking through the ducts of the breast, correct?
SPEAKER_00Yeah, that's right. So I think about you know, um I tell my patients breast cancer starts in the working part of the breast, meaning the part that's made to feed kids, and that's basically the milk glands, and then the ducts that carry milk to the nipples. And so I always think of uh the ducts, which is where most of the cancer starts, as kind of like an upside-down tree. At the nipple would be the trunk, and then as it goes into the breast, it branches into smaller and smaller, smaller little branches, and those are the ducts. And so under the microscope, a duct is hollow, kind of like a garden hose, and it should have kind of a nice orderly layer of cells that's growing in the inside. It's a living organ, and so you know, these cells grow and divide and die. Um, and then for some reason they pick up a genetic mistake that causes them to kind of grow wild, and then eventually they start to fill up the duct and then figure out how to eat through the wall of the duct and then get out into the kind of filler space in the breast. And that's where important stuff like blood vessels, lymphatic vessels live, and that's how breast cancer can leave the breast and then go somewhere else, and that's the most dangerous thing that breast cancer does. So invasive breast cancer means that it's invaded outside of the duct, and that can be a little bit more serious. It doesn't mean it has to be, but that gives the potential for the cancer to spread.
SPEAKER_01Right, so that's the kind I had, and then they said I had a grade two, which I did not know there was grades. Sometimes I would hear Joe talk about, you know, stages, stage one, stage two, stage three, stage four, but this was grade two. So they explained to me that that there's a one, two, and a three, and it's more about how the cells are behaving or how quickly they look either changing from normal cells or look different from the normal cells.
SPEAKER_00Yep, so grade is it's really subjective, so it's literally the pathologist, and I mean there's some science behind it, but like do they look really funny looking or not? So if they look more like regular breast cells, that's a lower grade. If they look really bizarre, like they're dividing a lot, those are the things that are.
SPEAKER_01Is that what they put in the medical record?
SPEAKER_00Pretty much, yeah.
SPEAKER_01Grade three is super bizarre.
SPEAKER_00That's that's my non-pathologist interpretation of it, but yeah, so grade two is kind of it's super middle of the road, so it's not super slow growing, not super fast growing, and so you we just never know if those are gonna be more dangerous or not. But generally, if it's not grade three, uh, that's generally a pretty good sign. So like I wasn't worried at all at this point. It's a little tumor, it's not very aggressive looking.
SPEAKER_01So then I got one nice thing in uh where I'm getting treated is they have nurse navigators and they assign somebody to you, and so that person called me and talked me through a lot of questions and kind of asked me how I was doing and let me know what was kind of coming up the next step, and that she would help guide me through all that throughout the process, which was really helpful when you're first hit with that news because it's pretty jarring and you just don't know what to expect. And um, I do remember that day I went to lunch with my mom, and I think I said to her um before we went to lunch, like, well, today could be the last day that I can say I don't have breast cancer because this afternoon everything might change, and it did. So, yes, October 31st. My last day I could say I don't have breast cancer, even though I did, but I didn't know I didn't. Um, so that uh the other thing that um was stressful a little bit too was waiting to find out if I was estrogen positive or negative, and progesterone positive or negative, and her too positive or negative, because whether my cancer is um sensitive to estrogen and hormones would determine treatment. And uh so that didn't come in for a couple days, I think, afterwards. So that was one of the times I was on high alert, like really, really hoping it was positive for estrogen and progesterone. And am I saying right, progesterone? Yeah, and um her two negative, which it was, so that was a that was good, but it was that was a nerve-wracking piece of waiting to hear more about what it was going on.
SPEAKER_00Do you want me to talk to you with those things?
SPEAKER_01Yeah.
SPEAKER_00So um, so breast cancer comes in different flavors, so breast cancer is not all the same, and we put them into really kind of three buckets. The the type we prefer to see, what I was hoping for you, is tumors that are estrogen and progesterone receptor positive, meaning that they feed on both estrogen and progesterone hormone. Those tend to be less aggressive, less likely to spread. Um, the third protein is called HER2. So HER2 is kind of the on-switch. It's present in all of our cells. When it's activated, it makes the cells grow. And so some breast cancers have way more of it than they should. Those tend to be very aggressive, and those are very treatable, but much more dangerous and have to be treated pretty aggressively. And then I wouldn't say it's the worst, but the one that we prefer not having is where all three are negative. We call that triple negative, and those are definitely more aggressive, um, and we always use pretty intensive chemotherapy for those kind. And so the nice thing is estrogen, progesterone, positive, HER2 negative, oftentimes we don't need to do chemotherapy, and I definitely did not want you to have to go through chemo, and so we were really relieved when that came back. Good.
SPEAKER_01Yeah. So yeah, one of the uh the other piece of information was the KI67 score, which is all things I've learned in the last six months, and the lower the percentage of that score often helps determine how aggressive the tumor cells are.
SPEAKER_00So KI67 is a protein that we look for that tells us if cells are actively dividing. And so the higher it is, the the more rapidly the cancer is growing. And so the the best combination is estrogen, progesterone, positive, and then with a low KI67, those tend to be much less dangerous cancers. And yours was I think it was seven percent, right?
SPEAKER_01Six percent. Give me credit.
SPEAKER_00That's that's real low. So you were you were uh kind of an all-star at that point.
SPEAKER_01One of the times during this whole thing when being in the low percentage group paid off for me, because I've had, as you'll hear, several other times I've been in a low percentage minority side effect group that haven't been so great.
SPEAKER_00Yeah, we had some curveballs.
SPEAKER_01Um, so yeah, so then that was kind of the start of a whole bunch of uh appointments, as anyone who's gone through this knows. Um, I had a surgery consult November 5th, lots of questions about what kind of treatment because they thought I had a one centimeter very small um breast cancer. They didn't suspect any lymph nodes, it looked like it was contained. It seemed to make the most sense to do a lumbectomy with radiation. Um, it would preserve the breast, and my cancer was further way further out on the side of my breast, kind of by my armpit. So it was kind of a good location to be able to remove things without really changing the shape of my chest very much. Um, so that's what we decided to do, and then the next thing I had the next day was genetic counseling, and another decision you have to make besides how much of your breast you want to cut off is uh uh how many markers for cancer do you want to get tested for, if any. I chose to do just the most common uh female cancer markers, and which were all negative, fortunately, um, but I could have done more, but I think they said, you know, if you do more and you find out you are more susceptible to certain cancers, there may be not really anything you can do differently, you know, even if you know that. And I thought my anxiety probably doesn't need a whole bunch of extra cancer risk that I don't know about. So um did that, and then uh we had a nice break in there.
SPEAKER_00And you don't really have a family history, no family history cancer.
SPEAKER_01That's the other thing. We do not have a family history of breast cancer on either my dad or my mom's side. I don't, I can hardly think of anybody that had breast cancer, and so um that was kind of a surprise because I had in my head, which I think a lot of women do, that it's family, you know, genetic, and it I think I've read majority are not.
SPEAKER_00Yeah, so yeah, um only only about 10, maybe 15% are genetic, so most of them are just random bad luck.
SPEAKER_01Yeah, yeah. I was just gonna say though, we did have a nice break in the action after having to kind of digest all this and think about surgery. We went to New York City November 7th for the weekend because I had gotten tickets earlier this that spring to go see Hamilton with Leslie Odom Jr. starring as Aaron Burr for a nine-week uh run, and that was awesome. That was a great break. It was good to get our mind off things. We had a really fun time, and it was just um yeah, it was nice in the midst of all this kind of yuck that was happening in November to October, November to have that break. Um, the other piece, because I did find out that my uh I was the ER positive um and the ERPR positive hormone cancer, I had an IUD in um to control my menstrual cycle because I'm not through menopause yet, and so I had to have that removed because that contains some hormones that they don't want seeping into your system. So I had to do that, and then I had to have a pre-op visit to get ready for my lumbectomy. Um, they also during the surgery, which I had in early December, they also took out three of my sentinel lymph nodes to check if anything had spread. And um, before that surgery, just an hour or two before they do that, uh you have to go in and they put two things you're laying on the table, and they put in a let me have Joe explain this, but they put in a mag seed, which is magnetic seed, that basically they guide in with the ultrasound to find the center of the tumor, and they plant that seed there, and then when the surgeon goes in, she has a tool that's magnetic, which basically guides that tool to that magnetic seed, attracts it, so she can start right in the center or right where the tumor is, so she's knows she's for sure in the right place, which I thought that was pretty, yeah, pretty interesting. They have that technology, and then they also um were putting in blue dye during the surgery, and the first three or four lymph nodes coming away from the breast would uptake more of that blue dye because they were the first ones to get stained, and then they know which are the basically the lymph nodes that are like the the exit guards to go to the rest of your lymph system into the rest of your body, and those are the three they want to take to see if you have any spread happening, correct?
SPEAKER_00Yeah, and sometimes it's uh it just depends on how they track. Sometimes it's just one lymph node, and then sometimes it's like five or six. Uh, but yeah, three is pretty typical. But um our data shows us that if there's no cancer in those first lymph nodes, then the likelihood that there's cancer in any other lymph nodes is really small. But if there is cancer in those first lymph nodes, then there is a higher risk that there could be cancer in some of the other lymph nodes deeper in.
SPEAKER_01And the other thing I forgot to mention they told me was they put basically a Geiger counter also in my breast, which they said um is basically putting um what's the material that they're putting in there? Um it's a radioactive radioactive, that's the word I was looking for.
SPEAKER_00Yeah.
SPEAKER_01I didn't have chemo berry chemo, but I do seem to have chemo brain. Maybe it's adjacent to Joe having.
SPEAKER_00You're doing great. Yeah, so it's sort of a backup system. Um sometimes when they eject the blue dye, it doesn't track like they expect it to, and so then they inject that radiocolloid, and then they can actually use the kind of little Geiger counter thing to see which lymph nodes take up the radioactive stuff first. So it's kind of weird to think they're injecting you with a radioactive. I know.
SPEAKER_01It was I was like, oh, that's interesting. I'm told it's safe, but yeah, so I had those two things done before the actual surgery. The surgery was fairly quick and not too bad. I had to go get a mastectomy or a lumpectomy type uh bra ahead of time because they want you to wear a compression bra that zips up. You can't lift your arms up very far when you first get your surgery done. Um, and you have to also do some uh exercises to keep mobility from the surgery. So there's a lot of layers. There's like your hormone layers of the IUD, there's thinking about your mobility and physical therapy, there's there's you know monitoring your incision site, there's there's just a lot of things to think about in a short amount of time. Um, and then when we got the results back from the surgery, that was probably one of my hardest days because um, for whatever reason, the imaging with the ultrasound and the mammogram was not accurate to what was going on in my left breast. And it ended up being three centimeters tumor, um, and one of My three lymph nodes had a three millimeter what they call macro metastases because anything over two you said is macro. So I did have in one of my lymph nodes, um, and that was hard to hear because I knew that put me at more risk of it spreading other places down the road. So that was a that was really a bummer day to say.
SPEAKER_00And then the margin.
SPEAKER_01Oh yeah, and then they also did not get clear margins, meaning they didn't get um they didn't get it all get it all. There was still some on the edges of the samples they took, so they knew they had to go in and carve out more to make sure all the cancer was out. So there weren't clear margins, it was bigger than anticipated, and I had a lymph node, and none of those things were what I don't think anyone expected based on the information we had in the imaging. And so I think one big um I and I've heard this from a couple other people, so I don't think this is all that unusual at all. Um, but I know with other women I've talked to have gone through something like this and things are unexpected, or they find a second cancer. I have a know a couple people that ended up having two types of cancer in their breasts but didn't know that until after the mastectomy, and it really shakes your trust and like um what you think is gonna be happening, what you expect to happen, and then when it's not that, even though all the professionals and all the imaging pointed to something, that's that is like it's kind of really hard to sort of digest, like how do I trust everything going forward now? Because what we thought it was is not what it is. So that is that can be kind of hard when you're feeling pretty vulnerable uh going through a cancer diagnosis. I'm sure that happens to all types of cancer, you know, with other patients as well. Um, but I know I've talked to a couple other breast cancer women that you know had that same feeling, so that's kind of part of the the emotional ride of you know going through this.
SPEAKER_00They do call it a roller coaster. Yeah, yeah, that was um I have to say I was really surprised. I I kind of felt like this was gonna be a early stage, no big deal. I mean, you know what I mean, no big deal, but yeah, low risk, you know, cancer, be chip shot lumbectomy, do some radiation, maybe some tamoxifen for a while, and and just kind of get on with life, not really that big of a deal. And so I remember um you called me and then you uh sent me screenshots of the pathology work because I was in clinic when you called me, and and um that's like through all the crap we've been through since October, that's the only time I've actually cried. It's gotta uh bring me back to that right now. Um because I did not want you to have to go through a I didn't want you my world, you know, pretty much. So that was that was a really hard day.
SPEAKER_01Yeah. Yeah, and and I'm it's kind of a weird um twofold thing. Seeing you cry, part of me was like, oh crap. My collegist husband just sat down and teared up and said, I'm so sorry, honey. And I'm like, that doesn't sound good. So that was that was one reaction I had. But the other reaction was it was actually kind of comforting that he did cry, or you did cry, I guess I can talk to you directly. We're here together, uh, that you did cry because um so much of your life as an oncologist, you're extremely good to your patients, you get close to your patients, you're very empathetic, they love your bedside manner everywhere. We go I hear how much Joe's patients love him. Um, but sometimes I think you can be more clinical or look at it more logically because you see it every day, you know. For me, this was new, this was not something that was my normal, other than hearing it through you. So I think to see you actually, it felt like you're reacting as my husband and not looking at it through an oncology lens, like, oh no big deal, it's gonna be just this or that. That's more the oncologist talking and compartmentalizing. And when you teared up, then I felt like that I needed that from you as a spouse, you know, because I needed to know that you were worried about me or cared about it, you know, in an emotional way, not just a logical way.
unknownYep.
SPEAKER_00Yep. That was an awkward day in clinic. Say that.
SPEAKER_01Did you tell anybody or did you not just keep it to yourself?
SPEAKER_00No, not really. Um, yeah, I didn't really tell anyone at that point. Uh I think I told people you were having, I think people knew you were having surgery, but I didn't tell anyone about the path report that day.
SPEAKER_01So yeah, and yeah, you were at work, and so my mom canceled her plans and came over and spent the day with me. Um just so I didn't have to sit with that alone. Yeah.
SPEAKER_00This is a common theme on a relationship. I'm at work.
SPEAKER_01Yeah. And my mom comes over. Right. This has been a theme in our marriage.
SPEAKER_00You've got the truth.
SPEAKER_01And I'm fortunate that both my parents are extremely supportive, live near us, and um, I'm forever grateful that we've had that family support for sure. And from your side, your mom too. Yeah, yeah. So um, yeah, so that was that was hard. So then I had to meet again with the surgeon and my oncologist and decide not to.
SPEAKER_00Say, what the hell?
SPEAKER_01Do you people know what you're doing? That's what I wanted to say.
SPEAKER_00I will say that really was so her surgeon actually had the radiologist go back and review all the films, had the pathologist review everything, and they said still can't see it. So it really was unexplained.
SPEAKER_01I think they said the the pathologist said the largest they could have said it was um radiologist. Or radiologist, sorry, was 1.8 or something. Um something like that. But it was three centimeters, so it wasn't even close. Um, but I do love the team. I've no, I mean, I'm just so happy with my all my doctors have been fantastic. But then I had to decide do I go in one more time and try to um or no, is this my first excision?
SPEAKER_00Yep, do a re-excision.
SPEAKER_01Am I gonna do a re-excision? Um, and she thought that she probably could get get it all to just go in one more time, scrape a little bit more out. And I said, What are the chances it's bigger than we think, or you know, it's gonna be more? And they thought it wouldn't be a problem.
SPEAKER_00So I went back to because it was only one positive margin.
SPEAKER_01Yeah, it was one, yeah, one one margin was not quite right, all the way clear. So then I think we went in, I think it was December 11th, so a couple weeks later, went in, did the reexcision, and then I had more margins that were not clear.
SPEAKER_00It was actually worse.
SPEAKER_01It was worse. Um, and I had one small spot that was another invasive.
SPEAKER_00Yeah, so a separate small area of invasive cancer, which you don't like to see when we think we got, you know, all the invasive stuff out, and then now instead of just one positive margin, and so the margin um initially was was so um almost always with invasive cancer, we also see non-invasive cancer or DCIS, and we have to get those margins clear too.
SPEAKER_01And DCIS stands for ductal situ.
SPEAKER_00Exactly, ductal carcinoma and side chew. Thank you. And uh, and so on the original specimen, it was the DCIS margin that was positive. And then on the re-excision, we had two or three margins now positive DCIS, even though she took a lot more tissue, and then a separate invasive cancer. So then you wonder, well, what the hell is in there that we don't know about?
SPEAKER_01Right. So that so then we had to decide uh they could have tried one more re-excision, or I could, but if they didn't get it all, then I would have to do a mastectomy. So I said, I feel like the writing's on the wall that we're heading towards mastectomy, and I'd rather not have to do two more surgeries. So I think it's time to just say we better take this breast off. And now I have a decision if I take off one or two.
SPEAKER_00The the other thing I think that factored into that was because the mammogram obviously was not accurate, yeah, and so you'd have to do MRIs as well as mammograms sort of indefinitely moving forward, and they're like, Yeah, how scary is that gonna be?
SPEAKER_01Yeah, because basically what happens if I would have uh done lumpectomy again, or even if I would have done probably just a unilateral mastectomy, then would alternate every six months a breast MRI where you lay in the MRI machine. Um, and I did one later on just to check the health of the right breast before I made my decision between unilateral and bilateral, just for some information. And also it gave me the chance to see what it is like to do a breast MRI because some people really don't like it. I don't tend to be too claustrophobic, but it it wasn't super pleasant. And about 15 minutes in, I thought, if I can't do this, then I just yell take me out, then my decision's made. I'm getting a double vistactomy. So um, and then it would alternate after the MRI the other six months you do a mammogram. But I felt like the mammogram was not a helpful tool for my breasts, and so I didn't feel confident that that was gonna find something because it hadn't, it should have probably found it a couple years earlier, and it didn't. So, um, so I spent a lot of time researching um about whether I wanted to do a single or double. And I talked to God bless my plastic surgeon, he let me call him at home and talk to him on a Sunday and ask him questions. I talked to I think 13, I'm not kidding, 13 women who were either friends of mine or friends of friends, or someone's relative who was willing to talk to me on the phone and share their experience, which was so amazing because some people did double, some people did flat closure and chose not to get reconstruction, some people did a unilateral and more of prosthesis on that side. Um, it was just kind of a gamut of all sorts of options, and it was really, really helpful to hear how they made that decision, what they liked and didn't like about that. Um, and it just gave me so much of a better picture of the different paths I could go down with this decision. And I will be honest, I chat GPT'd so much in January, much to my kids' chagrin, because I know it's not good for the environment, but I um I used AI a lot because I was really struggling trying to figure out what I was gonna do. It felt so permanent, and um, you know, identity loss, sensation loss, all those things, and more surgery, but at the same time, I didn't think I wanted to go through a scan every six months and not feel like I could trust that that scan was accurate anymore. And so eventually uh I did come to the conclusion to do a double mastectomy, which I had in uh January 21st of this year. That was a long, long uh sentence paragraph, whatever if you'd like to speak now.
SPEAKER_00Do you want to just talk a little bit about like what kind you decided to do? As far as tissue expanders versus Oh, yeah, yeah.
SPEAKER_01Okay, so I um yeah, so I'm doing just um I probably the less invasive kind of uh reconstruction surgery. So they took off both the left and the right breast, and then they leave drains in you that come out your side to drain during healing, which nobody likes those, and you have to measure uh and you know empty the bulbs that they drain into, and you have to I have several sweatshirts that you put the little bulbs in the pockets so that you can hide them when you're out and about. Otherwise, you have to wear kind of a velcro vest or not vest, a belt around your waist. You have to sleep on your back, you can't go on your side, you have to sleep elevated like 30 degrees or more elevated because you want the drains to drain. And I'm a slow drainer, and so my drains were in for three weeks before they stopped draining enough that they could be removed. Um, and they don't want them in too long because of risk of infection. Risk of infection. One thing that was not expected, you have a lot of well, this is expected to have swelling. However, I did ask the plastic surgeon at one point, I'm really concerned about the swelling around my back, be you know, on around the side under my armpit and behind behind there. And he very uh very quietly just said, I don't think that's all swelling.
SPEAKER_00It's very diplomatic.
SPEAKER_01I said, Are you telling me that's all back? He didn't really say anything, so I I think I think I know what the answer was.
SPEAKER_00He said, We can take care of that later.
SPEAKER_01But apparently, ladies, without your full breasts in the front, the back fat looks a little more obvious, so just be prepared. Um, but then yeah, so I have those removed and they put in expanders at the time of the surgery when they remove my breast and fill them just a little bit with some saline. So there's a little bit of a- You gotta talk about what those are? Oh, the the expanders are they're kind of mine, they're kind of a more oblong football shape. Um, they're just plastic kind of receptacles for saline.
SPEAKER_00They're basically just bags of water.
SPEAKER_01Bags of water, yeah. They look kind of like what you think a silicone implant looks, but but more um, they don't look it like they look more medicinal, I want to say. Like they have a circular metal hole on the front because when they're placed under my chest muscle, and then they're um, you know, they kind of look like you've got a little bit of a breast there, but then every week um you go into the plastic surgeon's office and they use a little uh magnet that is about the size of a pulse oximeter that you might wear on your finger to check your um oxy oxygen, I can't talk, oxygen levels. Um they find the magnet, the middle of the magnet, and then on one side a nurse is there, and the other side the doctor, and they're sticking very long needles into the into your breast, into those metal circles, so they can fill gradually with saline, which expands the chest, expands the muscles, and saves a place for your later the implants that will go in there. So um that's the kind I'm having. So I have fills every week till they kind of overfill you because I was gonna have radiation, and sometimes radiation can cause some uh damage or shrinking of the skin, so they want to make sure it's stretched out enough.
SPEAKER_00It feels like an oil change almost, it's very mechanical, yeah.
SPEAKER_01It's kind of hilarious. It totally is. That's why I said if like I'm coming for my yeah, my oil change every week. Fill me up.
unknownYep.
SPEAKER_01Um, yeah, they can be sore from being filled. Um, and eventually what would happen then is they would remove those and then after you've healed from radiation and then put in the more permanent uh silicone implants, and that's that's the route I took. Some people do other surgeries where they take skin from the abdomen and other areas and reconstruct the breast with that skin rather than using the silicone expanders, but it's quite quite a bit more surgery, longer surgery, longer recovery. So I wanted to do less surgery if I could.
SPEAKER_00Yeah. Do you want to talk about why you added irradiation?
SPEAKER_01I'm assuming it's because my lymph node was involved.
SPEAKER_00So so in the in the old days, as I said, um, if there's cancer in the sentinel lymph node, then we know there's a risk that there could be cancer in the lymph nodes higher up in the armpit. And so in the old days, we used to do a procedure called an axillary dissection where they literally went up in your armpit and scraped out as many lymph nodes as they could get. And that's a pretty horrible surgery. You know, it it causes chronic pain and shoulder problems. But the biggest issue is it really increases risk of lymphedema, which is swelling in the arm. And so there was a study done a few years back where they took women who had posicental lymph node and randomized them to receive radiation or surgery, and the outcomes from a cancer uh treatment standpoint were the same, but the women had radiation alone had a much lower risk of lymphedema and other complications, and so your doctors recommended doing radiation instead of more surgery.
SPEAKER_01Yes, and also um, I think didn't she do there was some sort of calculator out of MD Anderson Cancer Center that based on my information, I had a 20% chance another lymph node might be involved that we didn't take out, and so she felt like radiation was smart to do in my case.
SPEAKER_00Yeah.
SPEAKER_01Um, yeah, so I had that, so radiation. Yeah, and speaking of the lymphedema, I had a little bit of swelling in my left wrist, and I was a little bit worried about lymphedema. And I think just from talking to a lot of other people who've gone through breast cancer, that is a huge fear for a lot of people because they maybe know somebody that's dealt with it or it's been really, you know, problematic and hard to manage sometimes. And so that's basically it's when your lymph system is not working efficiently and you can get swelling and hardening, I think, eventually, right? In your arm, your wrist.
SPEAKER_00It's a bummer if you get the real deal for sure.
SPEAKER_01Yeah. So I was really worried about that. So I went early to physical therapy to just kind of do a check-in, see what I could do to prevent it. And then I did get a um, because I did have some swelling where my left arm was bigger than my right, um, I did get a compression sleeve and glove that I can wear while I'm up and about to kind of help support the lymph system um to not stress it out quite as much as it's healing. Yeah. And everybody would say, you've only had three lymph nodes removed. That's a really small chance you're gonna get lymphedema, but based on my experience with so many things through this cancer experience journey, I am usually in the minority percentage, so I am wearing my sleeve because I I'm just not gonna take a chance.
SPEAKER_00And then the other thing in the category of this socks is we had just, was it what September hit?
SPEAKER_01It got delivered in like October.
SPEAKER_00Yeah, spent 15 grand on this brand new hot tub that now she can't use for I don't know how long. So uh yeah, somebody wants to come out to our house and hang out in our hot tub so somebody at least can use it.
SPEAKER_01Partly because I had surgery, so you can't don't want to get the surgery site, you know, full of bacteria, but also the heat is not good for my healing lymph system, it stresses out the lymph the lymph system in my arm. So I'm waiting a while to use our new purchase.
SPEAKER_00But it's real nice.
SPEAKER_01Yeah.
SPEAKER_00So you finished the fills and then the next low percentage incident happened.
SPEAKER_01Yes. Um and in between all those, I just would like to mention there were weekly fills, there was physical therapy, I had to get my vitamin D level checked because Joe's had told me sometimes if you have a really low vitamin D level, it's good to well, and also because of some other medicine.
SPEAKER_00Oh, and then the sh did you mention the shots you've been getting?
SPEAKER_01No, I haven't mentioned those. So I got my vitamin D level checked, which is very low. So then I started on high dose vitamin D. I had to get a bone scan because I bone density. Sorry, bone density uh test because I'll be getting an infusion to uh of helping my bone density, right?
SPEAKER_00We'll talk about that later.
SPEAKER_01Maybe there's a lot of things, and then because I wasn't through um, I feel like I'm so inarticulate what I'm saying right now, but since I wasn't through menopause yet, um, we have to shut down my ovaries from producing estrogen so it doesn't feed the cancer. And so starting in the end of December, I have to go in, have been going in monthly, and I have to sit with an ice pack on my lower abdomen for about 15 minutes while I chat with the nurses, and then they stick me with a huge needle that puts a little pellet into my skin to basically shut my ovary production down. So I'll do that for a year, and if I'm still not through menopause, then I might consider taking my ovaries out at that time. Yeah. So on top of having a breast cancer diagnosis, they throw you into menopause as an added bonus feature, which is great. And then, you know, also a lot of women have to go to the mastectomy shop and you know get fitted for the sleeves or get fitted for special bras after surgery. So all that was kind of part of what was going on in the winter and spring for me, on top of just the regular doctor visits. Um, I gotten down to my last fill in my chest expanders, and so I was all ready for radiation finally to start. Um, and then I got I had to go into do a CT scan for radiation where they map out how they're gonna do the radiation beams on me, and they call it a simulation, and I got that done on a Thursday, and then Friday I went in for my ovary shot, the Zolodex, and I had a low-grade fever both Thursday and Friday. Didn't really know that I did, but I didn't feel great on Friday, and I knew I probably wasn't feeling quite right because Joe got donuts to bring to the staff, and I did not want to donate, and I thought something is wrong. Uh, and we got home from that shot, and I was gonna lay down, and my fever just spiked real high, and it got bad chills. And so went in to see the plastic surgeon. My fever was I think 103 at that point. I was just freezing, had coat on and multiple sweatshirts. I just could not get warm, and then uh ended up going to the ER where they put me on sepsis watch essentially because my your heart rate was 170 when you got there.
SPEAKER_00Yeah, so that that got everybody's attention.
SPEAKER_01Yeah, so I was they eventually they did start me on high dose antibiotics, but they had to take me in for a CT scan. Um, they found a small pulmonary embolism, which we think was because of the infection. Probably, but they couldn't figure out the source of infection, even though. Though Joe thought maybe it was my expander, but it wasn't presenting as typical because both Joe and my plastic surgeon told me, Oh, if you get a infection in your expander, you'll know it's so obvious, so red. Nope, mine wasn't. Mine was anything but obvious.
SPEAKER_00I can't imagine why you don't have confidence in the medical community.
SPEAKER_01Joe's always saying, Why don't you trust me when I tell you something? I'm like, have you seen what I've gone through the last several months? So anyway, um, they did, I got transferred to a different, a bigger hospital, and um they couldn't figure out uh what else it was, and it was spiking a fever on on this high dose antibiotics, and so they figured it had to be my chest expander had an infection.
SPEAKER_00So they took me in, and I did have a staph infection, and they had to remove the expander on the left side because that one was a little bit more red than the right one, which is why we were a little bit suspicious about it.
SPEAKER_01Yeah, yeah, but they were gonna do both if they had to. Um, and I think it's not super common, it's not like rare that it happens, but it's definitely not that, you know, the majority of people have an infection, obviously.
SPEAKER_00Especially that late. It's usually pretty soon after surgery. So yeah, I can't think I've seen anyone get one.
SPEAKER_01I was like uh two months out from my uh double mastectomy when when that hit. Um, and that was that was hard because um it it delayed everything. So I thought I was gonna start radiation, you know, the next week or so, and then I would hopefully get my expanders out in the fall and have my uh real uh implants in. Your real your real fake boobs. Yeah, kind of move forward, you know, um, and everything got delayed, so I had to wait and have drains again for two more weeks or more and heal from that. And so my um radiation got delayed another three or four weeks, which made me concerned because we were already 12 weeks out from surgery that my radiation was starting. Um I don't have an expander on the left right now, just on the right. So now I also have the experience of getting a prosthetic to put in my bra for the next six months, um, and then hopefully late fall I'll get a new expander on the left, and then I have to leave it in another six months, so I won't get the exchange to the new implants until probably next June. And that was that was hard because when this whole thing started, um, I thought I had a small cancer, and I was gonna have a little surgery in December and start radiation in January, and then be done and just be on pills, antastrogen pills in February. And now that went from like a three-month kind of you know, medical plan to 18 months.
SPEAKER_00Yeah. And then the other thing we forgot to mention, probably the most important test you had was that onchotype test.
SPEAKER_01Oh, yeah. Yeah. So uh when they did the surgery, they send samples of the tumor off to a company that doesn't oncotype, and they're basically studying the biology of the cancer.
SPEAKER_00Yeah, so oncotype is what's called a gene expression profile, so it measures which genes are turned on and off. And so in the old days, anyone with lymph node uh involvement would have gotten chemotherapy for sure. Um, but we have studies now that show that if the biology of the cancer is favorable, chemotherapy is not beneficial. And so the onchotype determines whether you need chemo or not. Also tells a lot about the prognosis of the cancer, and so you want a low score. And yours came back super low. Was it I had a 10. A 10, yeah, which is really good. Um, we want to see it less than 25. Um, and so that meant you didn't have to do chemo, thankfully.
SPEAKER_01Yeah. So um I've now I finished radiation, and that I can talk about that maybe in the next one.
SPEAKER_00Yeah, when did you and when did you finish that?
SPEAKER_01Oh 21st of May. Yep. So about a week and a half ago. Week and a half ago, yeah. Yeah. But I was wondering if I should save some of the radiation stuff for later because I wanted to just touch on Yeah, and we've gone pretty long already.
SPEAKER_00We're gonna be 45 minutes, but we're close.
SPEAKER_01Yeah. Well, I was just gonna say I wanted to just touch on, I mentioned several spots that were really hard emotionally, but I want to just highlight a couple of things that have been actually really wonderful, which sounds really strange. But um the amount of I and maybe people find this when they are going through hard stuff too, but the amount of support that Joe and I have gotten from family, friends, old co-workers, neighbors, you know, in the form of texts and cards and meals and rides to radiation and even going down to therapy, chemotherapy with Joe, um, it's just been pretty amazing, like how held and loved we felt. And also, Joe and I find it's very weird, but we feel very comforted that we're going through this experience together because um it's given us a lot of time together. And uh I don't feel alone going through it. You're not at work all the time while I'm navigating my stuff, and same hopefully for you, that we can both be here for each other while we're you know having to go through ups and downs, and and honestly, that's been like it's made me really feel at peace with a lot of stuff because I feel that emotional connection.
SPEAKER_00Yeah. Yeah, I agree. You know, it's been I don't know, people hear our story and it's like, oh my god, you poor people, but you know, we haven't really felt that way necessarily. I mean, it definitely hasn't been a woe was us kind of a thing. I mean, it hasn't been great. Obviously. I mean, rather not go through this, but but uh but yeah, it hasn't. It weirdly hasn't all been bad. So um so you want to talk about so what do you what do you got coming up in your cancer journey, Becca?
SPEAKER_01Let's see. Um I have to have an EKG baseline because I'll be starting some uh aromatase inhibitor, which is an anti-estrogen medication or estrogen blocking, is that correct?
SPEAKER_00Uh it just eliminates estrogen.
SPEAKER_01Eliminates, okay. Uh I'll be starting that soon, and also a different pill, which is you want to explain what a CDK 36 is.
SPEAKER_00Yeah, it's a different medicine that's a little bit more like a chemotherapy, it's a targeted therapy that makes the hormone therapy work a little bit better based on some very recent clinical trials that were published. And and you see your oncologist well.
SPEAKER_01Um I see my oncologist next, uh a week from Monday to June 8th. That's when I'll do my week from tomorrow. Yep. And that's when I'll probably start on the medication. Right. Um, and then just some blood work, I suppose, follow-up and some physical therapy follow-up for a while until we get closer to surgery later in the fall.
SPEAKER_00And your favorite shots every month.
SPEAKER_01Oh yeah, and my favorite shots in the abdomen every month.
SPEAKER_00Yeah, and then um, and then we're actually, and we'll get into this in the the next uh episode kind of about what I'm going through, but um I am on a clinical trial at the Mayo Clinic, and so actually we leave tomorrow because I've got a 6 o'clock a.m. PET scan at Mayo uh on on uh the 2nd of June, so Tuesday, and then I see my oncologist, and then I'll be at admitted to the hospital for a couple days to get some some real fun chemotherapy. Um, but we'll talk more about that. So uh next episode will be dependent on how I'm feeling out of this next round of chemo. Um, but we can uh we'll have some um so this will be my first PET scan since I was diagnosed, so we can see if this stuff is working or not. I think it is almost for sure, so I'm very optimistic. Um so hopefully I'll have some good news the next time we make one of these. Um but uh I think that's good for today. How are you feeling?
SPEAKER_01I'm feeling pretty good. I it was interesting to look back in our calendar and to see all the different appointments with all the different professionals and different procedures, and interesting to see how Joe and I's appointments overlap in the month of February and March. And uh yeah, and it is like you forget a lot of it because you're just going through one thing to the next. You have to just do the next thing, you know, and um, but I feel physically I feel good. I'm hoping that your chemo will be manageable this week.
SPEAKER_00Yep, yeah, yeah. I'm feeling optimistic. I think I'm gonna get good news on Tuesday and slightly dreading this next round of chemo, but but it'll be one more round closer being done, so yeah.
SPEAKER_01And Joe keeps using the excuse for anything he wants, like his new 77-inch television, that it's the wishes of a dying man, which I said technically we're all dying because we're humans, so I'll start making my wish list.
SPEAKER_00I'm gonna keep milking it though. All right. Well, um, uh that's it for us. Uh so thanks for listening in. So Joe and Becca, and uh we'll probably have the next one up in I would say one to two weeks, probably closer to two weeks. Uh, but hope you're enjoying this. Um, I'm gonna include, I did set up an email, so would love feedback if people have suggestions or thoughts on how this is going and or the things we should cover. Um, but I for now I think uh that's it for us.
SPEAKER_01Yes, and thanks for uh staying with us as we ramble through this. I had notes, but I I tend to go off of them. So we appreciate you uh sharing our story. And and for those of you who know us and have been supporting us, thank you an extra amount for all the love you've shown us.
SPEAKER_00Yep, yep, love y'all. All right, take care, bye bye.