It was a muggy August night at Wintrust Field, and Roxanne P. watched from the stands as the Schaumburg Boomers took the outfield in bright pink uniforms.
Tonight was Breast Cancer Awareness Night — an event she had helped plan for her employer. All around her, breast cancer survivors and their loved ones cheered as the Boomers thumped the Joliet Slammers 13-7, with proceeds benefiting breast cancer research.
Cancer awareness is a deeply personal cause for Roxanne. From a very young age, she watched the disease run through both sides of her family. Breast cancer had taken her maternal grandmother and aunt. Her father and uncle had died of pancreatic cancer, and their mother had died of brain cancer. And in 2017, her own mother was diagnosed with Stage 4 ovarian cancer and passed away Labor Day weekend 2018. So her biggest tear-jerker of the evening was when she got to place a pink “survivor” sash over the shoulders of one of the women in attendance.
She didn’t know it then, but that sash would help her get through the toughest chapter of her life, which began the very next morning. In the shower, Roxanne decided to follow the advice she’d been giving to women all night. She performed a breast self-exam… and found a lump.
Labor Day diagnosis
Roxanne was able to arrange for a mammogram at Ascension Alexian Brothers within two days. After reviewing the test results, her radiologist ordered an ultrasound and biopsy, performing both himself on the same day.
Over Labor Day weekend (almost three years to the day after her mother’s passing), Roxanne got the call from her surgeon.
“I knew what was coming. I think he knew what was coming,” Roxanne recalls. “But no real words were exchanged for a little bit. He kinda sat in silence and I kinda cried.”
Cancer doesn’t just happen to one person. It affects their families and friends and everyone who loves them. If you’re a working mother, you can feel added pressure to bury your feelings for the good of the family.
“I thought I was dying, like, tomorrow,” remembers Roxanne. “I was out-of-my-mind crazy but also calm at the same time because the biggest thing I was worried about was my kids. What are they going to do if I’m not working? Who’s going to do all this stuff?”
As Roxanne’s mind raced about whether she had enough life insurance, her surgeon brought her back with a single word: curable.
Roxanne was diagnosed with invasive ductal carcinoma (IDC). IDC is one of the most common forms of the disease, making up approximately 4 out of every 5 breast cancer cases. This cancer starts in the milk ducts of the breasts and then invades the surrounding tissue. If left untreated, it can enter the bloodstream or lymph nodes, where it develops into metastatic breast cancer. Luckily, IDC has a reputation for being “quick to grow, fast to die.” Roxanne was Stage 2, so there was still time. But treatment had to begin immediately.
“I’m going to be a survivor”
A cancer diagnosis can be overwhelming, which is why Ascension Illinois doctors and nurse navigators take it one step at a time with patients, giving them just the information they need to know to get to the next step.
“I think that educating patients and their families really does help the anxiety come down,” says Tinamarie Bauman, RN, MSN, APN, AGN-BC, ARNP, Roxanne’s genetic counselor at Ascension Illinois. “I try to give a lot of positive aspects about knowing and what we’re going to do moving forward.”
With her Ascension Illinois nurse navigator scheduling all her tests and doctor’s appointments, Roxanne was free to focus on what truly mattered.
Life doesn’t stop when you have cancer. Even as she was preparing to get her port implanted for chemotherapy, Roxanne and her husband, Jason, had to plan their three-year-old daughter’s birthday party. And she also had a one-year-old baby boy and seven-year-old son who needed her.
“I needed everyone around me to believe that I was OK, because the more people I had believing I was OK, the more I would believe that I was OK,” says Roxanne.
When Roxanne stumbled upon one of the pink “survivor” sashes that were left over from the baseball game, it made her realize, “I can beat this and I can live a really long, amazing life. I’m going to be a survivor. That is going to be me.”
Not your grandmother’s cancer journey
Roxanne had plenty of reason to be optimistic. She wouldn’t be going on the same cancer journey that her grandmother did.
“It’s a really exciting time in cancer medicine,” says Tinamarie. “We have so many great tools to use.”
Immunotherapy and monoclonal antibodies can use the body’s own immune system to attack cancer cells. Hormone therapy can block specific cancer receptors, essentially slamming the door on the fuel that tumors need to grow. Even “old” cancer treatments such as chemotherapy have been refined and enhanced through decades of clinical research.
Ascension Illinois and other health systems are building their capabilities with this exciting future in mind. For example, Ascension Illinois recently opened a new cancer center in Romeoville, IL. Outfitted with women’s imaging services, a full lab, a variety of exam rooms and private infusion therapy bays, and a hospital-grade pharmacy, the center puts comprehensive one-stop breast cancer care within easy reach of the Joliet area.
Each breast cancer patient, and their journey, can be as different as their fingerprints. In order to find the right path for them, patients typically start with tests. A lot of tests.
This period can be nerve-wracking for many cancer patients. “In the beginning, it’s like a roller-coaster where you’re inching up the ramp and you hear the chains click-click-click,” says Roxanne. “And then once you get to the oncology meeting, everything speeds up so fast.”
Roxanne’s test results were reviewed by the hospital’s tumor board, which consists of a surgeon, medical oncologist, radiation oncologist, radiologist and pathologist, among others. Her cancer was classified as estrogen receptor weakly positive (ER+). This breast cancer type responds especially well to chemotherapy, so the board recommended a 20-week regimen using a blend of medications nicknamed “the red devil.” This would keep the cancer from spreading and shrink the tumor so that it could be removed surgically. Roxanne ultimately took her doctor’s recommendation.
Wrestling the red devil
To her surprise, Roxanne was able to walk out of the hospital and play with her kids after her first of four chemotherapy cycles. But each cycle became more difficult. She admits that she almost gave up after #3. But Roxanne had many allies who helped her keep going.
“My nurse navigator [Melanie] was such an angel! Not only was I physically taken care of, but I was emotionally taken care of.“ Melanie always seemed to be there when Roxanne needed her, sometimes even at appointments where she wasn’t expected. Melanie checked in with Roxanne before and after treatments and surgeries. She was able to connect Roxanne with vital assistance from health psychologists, social workers and support groups. But she also saw to day-to-day needs: where to get a wig, bras, even a pillow to protect her breasts on the drive home after surgery. And she told Roxanne something all moms need to hear from time to time: “It’s OK to not be OK.”
Roxanne’s family also inspired her in surprising ways. When Roxanne’s hair started falling out in clumps, she wanted to make it fun for her kids instead of frightening. So she threw a head-shaving party. Everyone got to spray-paint their hair the color they wanted. Roxanne chose pink. Her daughter, Carly, picked purple. Little Carter got red. Luke, her oldest, went a little wild with red, blue and glow-in-the-dark. They ended by shaving Roxanne’s head and donating her hair.
“My favorite memory was when Carly curled up in my lap and said, ‘bye-bye, hair!’”
A “chemo buddy” helped Roxanne get through her toughest infusion therapy sessions. The two of them traded wig-wearing tips and found ways to laugh about what they were going through. Her friend gave Roxanne a certificate at the end for “kicking chemo’s keister.”
Chemotherapy was a success. In March, what was left of Roxanne’s tumor was removed during a nipple-sparing double mastectomy. As an extra precaution, she also had her tubes and ovaries removed due to her family history of ovarian cancer. After giving herself ample time to heal, she received breast reconstruction surgery in August.
Shared decision-making at every step
Throughout her treatment at Ascension Illinois, Roxanne felt empowered at every step.
“My doctors never told me what to do. They provided me with information to make the best possible decisions about my own health.” This meant that Roxanne ultimately decided what treatments to get, how much breast tissue to remove, and even how she’d like her breasts to look after reconstruction.
“There’s a lot more shared decision-making now,” agrees Tinamarie. “Patients get a lot more insight into the risks and benefits of each treatment option so that they can make an informed choice about their own care.”
When it came time for the first pitch at 2022’s Breast Cancer Awareness Night, Roxanne was there to throw it!