New focus: `I'm going to enjoy my time here'
September 25, 2008
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Tracy Huffman
SPECIAL TO THE STAR
A year ago, Lisa arrived at her oncology appointment with a list of questions and the doctor's own research in hand.
Diagnosed with a lesser-known type of breast cancer at the age of 34, Lisa wanted to be armed with all the information she could find.
"I knew I would have a lot of decisions to make, decisions that would affect my future," says the business analyst.
Lisa, who asked that her last name not be used, was diagnosed with a subtype of breast cancer called "triple negative," which accounts for 15 per cent of all breast cancers.
She read in research by Dr. Rebecca Dent that triple-negative typically affects younger women, the tumours grow fast and are often discovered at a late stage, since younger women may not do self-exams or go for mammograms.
Prevalent in Africans and Hispanics, it also has a lower survival rate than other forms of breast cancer.
But the Toronto woman, who is Jamaican-Canadian, says she was determined to remain positive.
"It is so important to be engaged in your treatment," she says, just days from the first anniversary of her mastectomy, the surgery she chose over a lumpectomy because the rate of recurrence is lower.
Lisa, who is single, knew she had to make decisions about her treatment that would impact her future, and potentially her fertility and body image.
"Having cancer has definitely had an impact on what my life journey will be," she says.
Unlike other forms of breast cancer, triple negative is estrogen-receptor negative, progesterone-receptor negative and HER2 negative, explains Dent, Lisa's medical oncologist at Sunnybrook's Odette Cancer Centre.
These three receptors are known to fuel most breast cancers, and treatments typically target these receptors.
However, triple negative usually responds to chemotherapy. It requires aggressive treatment as tumours grow twice as fast, Dent says. The likelihood of recurrence is twice as high and typically occurs within three years, compared to five years for other breast cancers.
Survival rates are much lower. In one study led by Dent, 42 per cent of triple-negative patients died, compared to 28 per cent of others within 10 years of diagnosis.
But Lisa stresses it "isn't all doom and gloom." Research shows patients who remain free of the cancer for eight years are likely cured.
Dent is currently a lead investigator in an international drug trial of 2,500 triple-negative patients. The study is probing the drug Avastin – already used for other cancer treatments – in combination with chemotherapy.
Lisa says such an aggressive form of cancer provides another reminder that early detection and self-examinations are key. "I was fortunate. I found the lump early and I had a lot of support."
She also has a lot of strength. She chose not to wear a wig when her shoulder-length hair fell out and is comfortable with her decision to have a mastectomy.
"The experience has made me appreciate life more and all the blessings that I have," says Lisa, who is back at work and feels strong and healthy.
She plans to help educate others about triple negative breast cancer and the importance of self-examinations.
She also wants to travel and visit friends in the United States and Caribbean. And she wants to see whales.
"I'm going to enjoy my time here."
Toronto Star