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“mBC may be the path we’re on, but it doesn’t have to lead to hopelessness.”

A family-focused wife and mom as well as an accomplished civil engineer

ABOUT NORMA, IN HER OWN WORDS:

• I have always been a person following a nontraditional path in a traditional world.
• Fourteen years after I’d thought I was done with breast cancer, all the fear came back.
• None of us know what our future is—no matter what we’re dealing with, the best we can do, I think, is try to look for new adventures.

Making Her Own Way in the World

I have always been a person following a nontraditional path in a traditional world. I learned early on to adapt and adjust to what life put in front of me.

I’ve lived my whole life in South Dakota—my mother still lives in the same community where she and my father grew up. I am the only girl and the baby of the family, born nine and 11 years after my brothers. Mostly due to the ratio of boys to girls in my life, I became used to being different. My first seven years of school were in a one-room country school where I was the only person in my grade level. There were three boys in the grade above and two boys in the grade below. Recesses were spent playing football and chasing gophers.

When it was time for college, I didn’t want to follow the traditional avenues available to girls back then. My older brother was an engineer, so I decided that’s what I’d be too. Not many women were pursuing a degree in civil engineering. But I liked the discipline of it. And, in engineering, as in nature, you learn to adapt and adjust in order to keep moving forward. That “adapt and adjust” attitude has probably served me well on my breast cancer journey.

I am a certified corrosion specialist. One of the dictionary definitions of “corrode” is to weaken or destroy gradually, to undermine. As an engineer, I’m an expert in the more technical aspects of the word. And, as a person living with mBC, I understand both senses of the word on a deeply personal level. It’s said that everything “corrodes,” be it metals (my specialization) or bodies. But I think there’s one thing that doesn’t have to corrode—the spirit to keep fighting an ongoing disease, such as mBC. mBC may be the path we’re on, but it doesn’t have to lead to hopelessness.

Adapting and Adjusting to a Diagnosis

I got married and then found a dream job as a field engineer for a natural gas pipeline. I loved it—and over time, as I mentioned, I became certified in corrosion control. Part of my job was to do what I could to prevent corrosion, spot areas of weakness, and decide on the approach that might work best for that particular situation.

Unfortunately, the company I worked for experienced business difficulties and I found myself looking for a job. I found one two blocks from home: teaching construction management at a state university. This was the very last thing I expected to do for a living. But with time it seemed to fit my lifestyle as it provided flexibility for me to spend time with my family. Sometimes we go where our paths lead.

Then, on Thanksgiving Day 2004, something felt off. My breasts were puffy and sore. That night I felt a lump in my left breast. Rather than get too worried, I waited. My breasts were always lumpy but this lump felt different. It was kind of gritty. After two weeks, the lump was still there. At my husband’s urging, I went to the doctor. The doctor reacted immediately after feeling the lump. His reaction is what scared me. Arrangements were made for a mammogram. After the mammogram came the ultrasound. A biopsy was scheduled for the Monday after Christmas.

I dreaded telling my mother what was happening. Her mother, my Grandma Lydia, had died at 64 of breast cancer and six of her siblings had also died of cancer. One of her sisters died at 37 of breast cancer. On Thursday, the results came back positive. The surgeon had me come for an appointment right after lunch. I’m certain I didn’t eat lunch that day. During the doctor visit, my husband and I decided it was best to follow the doctor’s recommendation and have a mastectomy. Fortunately, he had an opening the next morning, which happened to be New Year’s Eve. Now it was time to tell my mom. She took it as well as a strong lady from the Greatest Generation with German ancestry would be expected to do. I just remember hearing her say, “I’m sorry.”

Handling the Impact All Over Again

My first marriage had ended in divorce, but I’d remarried a fine man, Cliff, who had four boys. With my son and daughter from my first marriage, six kids in the house made for a very lively home. My kids were with their dad when I received my breast cancer diagnosis, so I didn’t tell them until they were with me again after surgery. They both seemed to accept the news well. Amazingly well. It helped that Cliff kept a light spirit and provided his twisted levity to help distract me from moping. His creative humor also, I believe, helped the kids process and accept the situation.

Many years later, I asked my daughter, Morgan, how she felt about it back then. She related I had told her I would be all right, so she believed it would be. I remember saying it to help provide comfort, but I had been shaking in fear inside. Still, as a corrosion specialist, there was a certain satisfaction in knowing that the weakness in my body had been spotted, treated, and stopped.

But it hadn’t been stopped. Fourteen years after I’d thought I was done with breast cancer, all the fear came back. It was fall and I was making plans to expand my hobbies, enjoy more time with Cliff, and write research papers for fun. I even had that great feeling of relief that things were going well. While out of town, however, my armpit got puffy. That night in the shower I felt a lump. During the summer, something about the lymph nodes in my left armpit felt “off” to me. It also seemed like my weight was shifting; my bras were getting tight even though I wasn’t gaining weight. My back would occasionally be sore, but I wrote that off to age. Lying in bed, my hands would tingle—another sign of age that went with my back. Nothing intense, just there once in a while. After my previous breast cancer experiences, this time, I didn’t wait to see the doctor.

A biopsy and scans were completed, and the surgeon gave me the news that my cancer had returned. I unraveled. This Stage IV diagnosis was much worse than my initial breast cancer diagnosis. I cried. And cried. And cried.

It was again time to tell Mom. This time was harder as Mom had now become dependent on my help. She was stoic afterward, and she no longer confided in me the same way. I know she was trying to protect me; she didn’t want me to worry about her and take care of her when I had my own medical problems. I couldn’t help feeling like I was letting her down. Emotionally it was very difficult. My mother is a very private person and she isn’t as comfortable telling my brothers about her health or asking them for anything. Who would take care of her if I couldn’t?

Getting Underway with Treatment

The time between receiving the PET scan results and the oncologist appointment was emotionally exhausting: I felt like a basket case and I prepared for the worst. A visit with my oncologist helped to ease my anxiety. We have a great doctor–patient relationship. He listens to me even when I worry about small pains that end up being nothing.

He told me about a treatment indicated for adult patients with HR-positive, HER2-negative advanced or metastatic breast cancer. He seemed knowledgeable and comfortable with that treatment plan: IBRANCE and letrozole, which is an aromatase inhibitor.

He went over how IBRANCE worked; he was very clear and concise about it. He had the pharmacist come in and talk with me so we could make sure all my medications and vitamin supplements were compatible. The pharmacist gave me a welcome packet and we went over the potential benefits and risks, including the serious and common side effects of IBRANCE. He also suggested I call Pfizer Oncology Together to find out about financial assistance resources. Everyone’s situation is different, but I was able to enroll in a co-pay program for eligible commercially insured patients, which was nice…one less thing to think about.

Learning about the medication gave me peace of mind. The term “inhibitors” was a familiar one: in civil engineering, inhibitors are chemical compounds put in metal holding tanks to treat the liquid and make the environment less corrosive. They help slow the corrosion rate. Now, medicine obviously isn’t metallurgy, but it felt good to understand the theory behind a treatment. I have experienced side effects, including low white blood cell counts, which my doctor continues to monitor. Of course, this is just my experience and everyone’s experience may differ. Others may experience other serious or common side effects, including lung problems or infections.

Embracing Gratitude

My doctor told me this diagnosis doesn’t have to define me. Those simple words have helped me many times to realize I am still the same person. In corrosion there are “sacrificial anodes,” highly active metals that are used with a less reactive metal that’s in danger of corroding. They sacrifice themselves to protect a structure. But I don’t have to sacrifice my sense of self in order to fight mBC, to fight for hope.

None of us know what our future is—no matter what we’re dealing with, the best we can do, I think, is try to look for new adventures. Today, I am grateful for the ongoing medical advances in metastatic breast cancer. I am grateful for life.

_{Ambassadors were asked to share their personal stories about IBRANCE. All content was accurate at the time of publication and may have since changed.}

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