“In October of 2019, my sister Alex was diagnosed with Breast Cancer. She was 34 years old and eighteen weeks pregnant. Alex had two miscarriages before this pregnancy, so she was extremely nervous from the day she found out she was pregnant. Alex always wanted to be a mom and was beyond excited to enter the second trimester. She felt relieved to be past the first trimester and was confident things were finally falling into place. This sense of peace and happiness would only be her reality for a few short weeks.
At eight weeks of the pregnancy, Alex discovered a rash on her left breast. She assumed it was a result of a bra that had grown tight due to enlarged breasts and the August heat. She mentioned it to her OBGYN at the next appointment, but he did not think it was anything to be concerned over. The doctor also did a physical exam of her breasts to see if he could feel anything. There was no sign of a lump or any other irregularities. Around week fifteen, Alex noticed dimpling in her skin right by the spot of the rash. She described it as an orange peel. She googled ‘dimpling of breast’ and CANCER popped up on almost every link. The next day, Alex went to an urgent care and was told it must be a clogged milk duct causing an infection and was given an antibiotic. On Monday morning, her OBGYN followed up and recommended speaking with a breast surgeon.
The breast surgeon examined Alex and could not feel any lumps or swelling. She instructed Alex to finish the antibiotics and come back in a week. When Alex returned, the breast surgeon was going to just biopsy the skin, but Alex asked for imaging. It was during the ultrasound that day, week seventeen of the pregnancy, that a mass and a swollen lymph node were discovered. The surgeon quickly assured Alex it did not look like cancer, but they needed to biopsy the skin, the mass, and the lymph node. This all happened on a Wednesday. Alex tried to focus on those words, ‘It doesn’t look like cancer,’ but she knew. She said she just had a gut feeling.
The next few days felt like an eternity waiting for the results. Alex’s boyfriend, Jeff, took her shopping for maternity clothes to distract her that weekend. Monday afternoon, while walking her dog, Alex received the dreaded phone call. The doctor started by saying the results from the skin biopsy came back negative for cancer cells. Then she moved on to the mass…’It is a small cancer,’ she said. Alex was in shock, alone walking her dog with her pregnant belly when she got the news that would forever change her life. I will never forget the call. Her crying as she told me, ‘It’s cancer, oh my God, it’s cancer.’ I then had to tell my parents their pregnant daughter had cancer. I will never forget the heartbreak and terror they experienced when hearing those words. Sharing the news with the rest of our family and friends was not easy, either. Is this real? Is this really happening? I just kept thinking that over and over with each conversation I had. Truth is, I still cannot believe this is our reality.
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Initially, Alex was told it was Stage 1, but they needed to re-biopsy her lymph node and skin to make sure. The original biopsy of the lymph node was not viable as they missed the mark and got a piece of tissue in their sample. They would also go on to do four more skin biopsies, making sure to get all the layers of the skin. The surgeon needed more skin samples to rule out Inflammatory Breast Cancer since Alex had skin dimpling. Jeff and I spent all day at the hospital with Alex while she got five more biopsies done, a mammogram, ultrasound of her liver, and a chest x-ray. That same day, as soon as we got back to her apartment, Alex ate two slices of pizza. I looked at her and said, ‘How are you eating right now?’ She looked down, pointed to her stomach and said, ‘I need to make sure she is okay.’
The first few days after diagnosis kind of all blends together. From the day of diagnosis, it was always clear Alex was going to do everything and anything to not only fight for her own life, but to fight for two. At the first few doctor appointments, the only question I can remember Alex asking the doctors was, ‘What about the baby?’ At one point, she asked to delay treatment until she was born, but doctors said that was not an option. The days were a blur, but there will always be moments that show you the true depth of cancer. Moments that show you what the day to day, week to week, month to month, and so on, entail. Alex often describes cancer as a full-time job because it seems never ending. Cancer is so much more than chemotherapy, radiation, and surgery.
During that first week, I was driving to work when I received a text message saying, ‘Alex’s breast surgeon called and said to get to the hospital immediately.’ I called Jeff to see if he had any additional information and the only thing I could hear was her crying and screaming in the background. Based on the urgency of the call from the doctor’s office, Alex had assumed the surgeon was going to tell her it was Inflammatory Breast Cancer. I turned around and met them at the hospital. The doctor walked in and said, ‘We need to do some additional biopsies.’ That day, she had 21 markers placed inside of her – she was awake for all of them. She later told us at one point her whole body jolted from the table and she felt the baby move at the same time. A few days later, Alex would meet with her newly appointed oncologist for the first time.
Jeff and I went with her to the appointment. Alex was the youngest person in the oncology suite and people were staring at her pregnant belly. This was obviously not a situation people were used to seeing. We sat in the room, bracing for the worst but hoping for the best. Maybe they would tell us this was all a mistake or a bad dream. The oncologist had the results from the latest rounds of biopsies. All the skin biopsies were NEGATIVE! The samples showed psoriasis dermatitis. This means the rash was not related to the cancer/tumor on the other side of her breast. Alex believes there was a divine intervention in the timing of the rash and pregnancy. She needed to be pregnant at this exact moment in order to find the tumor and swollen lymph node that could not be felt. She would have no reason to get imaging before the age of 40. Alex always says her daughter saved her life and we all believe that. Personally, I believe, that baby saved Alex in so many ways during this dark and unimaginable time.
Alex’s oncologist shared that her tumor was triple positive. This means pathology found estrogen, progesterone, and HER2 receptors in her tumor. He assured us the medicine and treatment available for triple positive cancer was particularly good. The oncologist also shared the lymph node was negative for cancer. This was cause for celebration! Alex was so relieved after hearing that, but the relief would be short lived. The next morning, he called to tell Alex this was a mistake. The new pathology results showed a small trace of cancer in the lymph node, placing Alex at Stage 2 Invasive Ductal Carcinoma. Alex’s liver ultrasound and chest x-ray were negative and showed no abnormalities. Alex went for second and third opinions. While many of the doctors who reviewed Alex’s case felt confident this was not Inflammatory Breast Cancer, there were a few doctors who did not want to rule it out. All the doctors agreed on the treatment plan being aggressive, but were cautious to protect Alex’s baby.
When we met with the nurse navigator, she walked us through what to expect over the next couple of months. I remember Alex saying, ‘You can take my hair, you can take my boobs, I just want to live, I love my life.’ Those words will never be forgotten. A few days later, we were at a chemo consult to review the details and side effects of the chemotherapy drugs she would be receiving. This time when they mentioned hair loss, a few tears fell and Alex quietly whispered, ‘You just look so sick without hair.’ When I gave the recap to my dad, he started crying at the thought of Alex losing her hair.
My mom and dad offered to pay for Alex to try the freeze cap to prevent total hair loss. There was no guarantee the freeze cap would work, and it was intense! When they took the freeze cap off, there would be actual icicles covering her entire head. Alex had to put the cap on two hours before the treatment and an hour after treatment. Some days she was in the infusion chair for eight hours. It meant a lot to her and she was willing to fight for even the smallest things, like her hair. Alex made it known it was not a vanity issue, but rather a self-identity issue. With each clump that fell, she felt she was losing a piece of herself. Unfortunately, after just two rounds of chemo, her hair began falling out in clumps. Those seemed to be some of her most trying days. Alex would not look at herself in the mirror, and she wore a hat around the clock, even to bed. But after about a month, Alex knew it was time to shave it. I drove her to the salon, and she bravely sat in the chair while the hairdresser shaved off all that was left. Not one tear fell from her eyes, but I had to fight back mine.
In the beginning, I was not sure how she was going to fight this battle. Alex was the quiet one growing up. Alex hates confrontation; she always has. She has always been soft-spoken. She always looks for the good in people and is usually the politest person in the room. We used to joke that if she ever got picked for the Hunger Games, I would have to take her place because she would never survive. From the day she first sat in that chemo chair, it became clear she was more than equipped to fight for her life.
Just three weeks after diagnosis, Alex and baby, Daniella, began receiving one of the strongest chemotherapy drugs, Adriamycin and Cyclophosphamide, available to cancer patients. It is often referred to as ‘red death’ or ‘red devil.’ We had bought Alex a chemo bag and packed it with all the things she could use to pass the time and manage the symptoms. Alex started crying when she opened it. She apologized for crying and did not want us to think she was not appreciative. She wiped her tears and said, ‘I should be opening baby gifts, not cancer gifts.’ That first day of chemo, when I walked into her infusion room and saw her sitting there, I remember thinking ‘she’s ready.’ She looked different to me. Tougher and braver than I could ever imagine being.
Before every round of chemo, before every scan, Alex would clutch onto her stomach, and you could tell she was begging that little girl to hold on for just a little longer. Alex and baby were closely monitored over those four months. Getting Daniella here healthy meant everything to Alex. She did everything in her power to try to prevent Daniella from feeling any stress or pain from the situation.
In order to prevent the baby from exposure to Taxol (second chemotherapy drug), Alex’s doctors decided they would need to take the baby out four weeks early. A risk of chemotherapy during pregnancy is low birth weight and Daniella was always measuring on the small side. Alex was also having a hard time eating and drinking on the chemo, so she was nervous about the weight of the baby. Daniella was born at thirty-six weeks and four days. She was only four pounds, but you could tell she was fierce! Daniella spent eleven days in the NICU and went home three days before the Covid-19 pandemic began in this country. Three weeks later, Alex would resume weekly chemotherapy for twelve weeks.
Due to hospital protocols, Alex had to go to all treatments alone. She drove herself to and from the hospital every week. For four months, the only time she saw her family and friends was through a glass door. There were days her body looked like it could not take even one more round. Chemo made her so sick, and she always looked tired. The emotional pain seemed to be so overbearing some days. Cancer is traumatic, but cancer while pregnant and then during a pandemic is incomprehensible.
Every week she walked into a hospital filled with Covid patients and the national guard. The news reminded you that cancer patients were at severe risk of Covid complications. One night I woke up to one of the longest texts I have ever seen. Before I read it, I knew what it was. The text message included the passwords to her accounts, a list of gifts to buy Daniella for all her birthdays until she would turn 18, and a few other things she wanted Daniella to know. She was petrified something was going to happen to her. Covid brought out her worst fears. Instead of telling her she was not going to die, I told her the only truth I could tell her. I told her if anything ever happened to her, Daniella would always know how hard she fought for her life, she would always be taken care of and raised with the most love possible. That night I sat up for hours crying, imagining a life without her. But even worse than that was imagining what it must have taken for her to type that to me. How much she must have cried writing it. How many nights she spent sitting up thinking there was a possibility she would not get to watch Daniella grow up.
After what seemed like forever, she finished 16 rounds of chemo and had a new set of scans done. Doctors could not see any sign of cancer in her breast or lymph node. Her scans were clear. It appeared the chemo did exactly what it was supposed to. They put the option of a lumpectomy back on the table. Alex really wanted the lumpectomy, but in the end, after two surgery set-backs due to an infection and a false positive Covid test, she chose the double mastectomy. She chose this option for herself, and her family. Due to Covid-19, Alex had to go in alone for surgery, but she did not complain. When she woke up alone in the recovery room, she asked if they called her family and told them she had a five-month-old baby at home waiting for her. The pathology report from surgery came back positive for microscopic amounts of cancer, in both her breast, and one lymph node. The surgeon removed ten lymph nodes in total. The other nine were negative for cancer.
In addition to the sixteen rounds of chemo and double mastectomy, Alex went on to receive twenty-eight rounds of radiation and 16 rounds of immunotherapy. She is also taking medicine to keep her ovaries shut down and the estrogen in her body suppressed. This will continue for five to seven years. This treatment plan gives Alex what doctors said were her best chance at a 30+ year survival rate. As Alex always says, and of course with the biggest smile on her face, ‘I will take those 30 years!!!’ And so will we. She is so thankful every day for the hope of 30+ years.
Cancer has changed her body. Chemo has changed her body. Radiation has changed her body. Every morning when she gets dressed, Alex is reminded of what she has been through simply by looking down. Cancer has taken so much from Alex, but it never took who she was before cancer. Alex believed in ‘you only live once’ long before cancer was a part of her life. Alex has always and still does live for all the little things. She finds joy in each day, in even the smallest of things, like the perfect cheeseburger. She has been fighting for over 500 days and there has not been one single day she has not smiled. Alex still has a long road ahead of her, but she still has so much fight left in her. Her determination and will to live is greater than any fear.
Daniella is thriving and recently turned one year old. Daniella is the driving force behind Alex’s strength. Alex and Daniella spend every day together and in some weird way, that is a gift cancer gave her. After requesting additional time for medical leave, Alex was let go from her job right after she finished radiation. Alex was working as a Preschool Director before her diagnosis and had over ten years’ experience in this field.
When Alex was first diagnosed, she wanted to keep everything private. She also did not really want to talk about it much. It was extremely overwhelming. After a few months passed, Alex realized the importance of community when dealing with cancer. She found comfort and courage in talking with other women in similar situations. That is when we decided to start The Fight for Two Foundation. The goal is to support others fighting the same fight. The Fight for Two Foundation provides snacks to local hospitals, care packages, and other resources.”
This story was submitted to Love What Matters by Ashley Belluzzi.
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