5 Years Cancer Free: Babies After Breast Cancer

When I first started thinking I’d be lucky enough to celebrate 5 years free of cancer, I imagined that I’d host a huge party with everyone I knew. The 5-year NED (“no evidence of disease”) mark is sort of a magic ticket in the cancer realm, a sign that, if you’ve managed to outrun a recurrence for five years, you’re likely cured of the disease. It’s not a surefire guarantee, but it’s enough of a reduction in cancer risk that an oncologist might dismiss a patient after 5 years of follow-up. Though future cancer is always possible (anything is possible, though, right?), I wanted to celebrate this landmark event.

There’s a tricky thing about life, though: it gets so busy and unexpected and, if you’re anything like me, it’s always pretty random. A party didn’t pan out this August for multiple reasons, including a crazy schedule complete with a family wedding, back-to-school shenanigans, birthdays, etc. We roll with the punches over at our house. So today, to celebrate 5 years cancer free this month, we relaxed with a chill morning in, attended a local picnic with our Filipino-American Association, went raspberry-picking, and ate a delicious mocha tres leches cake made by a church friend. A random and fabulous day.

A part of me thought, shortly after I entered remission, that celebrating life had to mean big, wild gestures, like throwing a huge party, or skydiving, or traveling to an exotic, far-off destination. I mean, I do like a good party, and I’d love to travel the world (though my fear of heights makes me wimp out on rollercoasters, so I don’t think anyone can convince me to go skydiving), but then I realized that celebrating life actually isn’t in the big gestures; it’s in the joy that you find while living. Maybe for somebody, that’s falling from the sky at Mach speed, but for someone else, it might be something entirely more laidback. Like a beach day. Or finding your dream job. Or spending more time with loved ones. And, honestly, I think that one concept can sum up everything I’ve learned in the last few years since cancer treatment: embrace what brings you true joy in life.

That said, I still reserve the right to have a random huge party, maybe next year. 😅 Another fork in the road that I definitely didn’t anticipate is that I would be 8 months pregnant on my 5-year NED anniversary.

At my first appointment with my oncologist, on January 7th, 2020, he asked if I wanted to have my eggs frozen. I was blindsided for a bit because 1) I was 9 months pregnant at that appointment, so I felt like that part of my body was a wee bit busy at the moment, and 2) I thought I’d just been given a death sentence with a cancer diagnosis at age 32; I couldn’t perceive even the short-term future. I laughed in a bit of a tongue-tied way and managed something like, “No, that’s okay; I have three kids already, counting this one.” My husband and my dad, who were both with me as moral support, acted similarly.

Then, my oncologist launched into details of my breast cancer diagnosis, and his initial words were forgotten when I heard him utter the phrase “potentially curable”. We hear about a distant “cure for cancer” as though it’s the unattainable holy grail; at the time, I’d had no idea some cancers had already located their holy grail. My cancer sub-type could potentially fall into that category, depending on how far it had spread and how well my body reacted to treatment.

It was still a luck of the draw (as so much of cancer is), but I learned early in treatment that my breast cancer sub-type, HER2+/ER-/PR-, was an aggressive one originally known for a low survival rate until a recent miracle drug, Herceptin. The drug meant that, though my cancer subtype had an incredibly low rate of survival prior to the late 1990s, it now boasted an average 90% 5-year survival rate. (I highly recommend watching the movie Living Proof; it stars Harry Connick Jr. and covers the process of Dr. Dennis Slamon’s trials with Herceptin from 1988-1996 and how it was finally approved by the FDA for patient use in 1998, saving millions of lives since then.) For me, this drug might be the holy grail.

Treatment took up most of 2020, and that year felt chaotic in so many ways. I was fortunate that the cancer hadn’t spread beyond my lymph nodes and that I had a complete response to chemo, being gratefully cancer-free since summer 2020. Suddenly, I was out of the deep trenches of cancer treatment and raising three little kids in the upside-down world of a global pandemic.

Parenthood becomes complex after cancer. Not only do you realize your own mortality, and that of your children, more intensely than your cancer muggles counterparts, but you also see life from a new perspective. Knowing that, had I lived in any prior generation, I wouldn’t have received my miracle drug and wouldn’t have survived past my 33rd birthday made me incredibly grateful for each and every moment. Each sunrise was worth celebrating. Even when my kids or students got on my nerves, I could return to a state of gratitude at a fairly fast clip. Who cares about a minor inconvenience? I was alive.

However, along with gratitude, survivorship also brings guilt: why did I get to survive when others didn’t? Five young mothers immediately come to my mind: women I had associated with whose lives were stolen by cancer in what should have been their prime. Cancer is bitterly, painfully unfair. Being a part of the cancer community means getting to know amazing, strong people, some of whom will be there with you for years, others who won’t be around in a few short months. Sometimes it’s impossible to tell. People hate to hear that so much about cancer is luck, because they want a guarantee. This is especially true for people who don’t have cancer; they want a guarantee that their healthy lifestyle will keep them cancer free. But sadly there is no guarantee.

When you enter a new community, your perspective shifts. I reinforce to my students the idea of reading and listening to others’ perspectives– “taking a walk in another person’s shoes”, so to speak. Many times, my students have grown up in a small town, surrounded by people who look and sound like them. It’s difficult for them to realize how different life can look to someone else from another country or ability or race. I have used my experience with cancer as a way to lean into this, by telling them about issues I didn’t know existed until I entered the world of adolescent and young adult cancer. “There will be issues that you’ve never had to think about because they don’t affect you personally. It doesn’t mean that these issues don’t exist and that they aren’t a vital part of someone else’s life.” We talk about listening with intention to others.

A few probably roll their eyes internally, but I like to think the message resonates with others. Any community is like that, and as you immerse yourself further into the community, you learn their challenges and strengths, their hopes and despairs and joys.

One aspect of the AYA cancer community that can be particularly close to some is fertility. Discovering that led me to understand my oncologist’s early words to me about egg preservation; they had seemed so out of context at the time, but I realized he was doing due diligence that many oncologists forget with their young patients. Many young women who dreamed for years of being mothers are suddenly told they cannot have children due to treatment or surgery. Some are thrust into treatment before they even learn about this possibility. This is heartbreaking. I have felt guilty because I had three children already before beginning treatment; was I greedy to have three when some have none at all?

That thought haunted me in summer 2022, when I found out I was pregnant again. I panicked immediately. Last time I was pregnant, I’d been diagnosed with cancer. The genetic counselor and my oncology team couldn’t rule out that pregnancy had been the trigger that set off my genetic mutation, but nobody knew why. I was terrified, certain the cancer would return. I prayed for the pregnancy to instead go to someone who was struggling to have a baby: maybe one of the women I’d come across in online support groups with names like “Babies After Breast Cancer”.

I miscarried around 8 weeks, and it was a sad experience, but my unreasonable mind also thought, maybe I was safe from cancer now. When I heard about a friend who, struggling for years with IVF, had suddenly conceived at just the same time, I couldn’t help but smile and tear up. That was what was supposed to happen. I was so happy for her, and for the other friends and coworkers who experienced positive stories about pregnancy and childbirth after cancer or other fertility struggles. I regularly pray for people to get their miracle babies.

My oncologist met with me shortly after my miscarriage, for a regular check-up. “You should focus on yourself and your health right now,” he told me. “It may take twice as much time to recover from treatment, as much as three years since you were in treatment for sixteen months. I think it’s unlikely that you’ll have another child. But your health is priority. For you and your three little boys.”

“I know. And that is totally fine!” It was. I was so, so grateful for my family. Time to move onto the next stage of life.

Fast-forward three years, and we’re very surprised to be expecting a daughter in early October! Unbelievably, I have felt more grounded during this pregnancy than I have during any of the others. Though I’ve been very cautious, and I was not as quick to share the news widely, I am feeling at peace. All my doctors are keeping an extra close eye on me and this new baby. Everything is going smoothly, and I no longer have the (somewhat) irrational fears that cancer will return during pregnancy. My husband and I even talk about long-term adventures and plans with our soon-to-be-4 children in the future, and we’ve even discussed crazy, extremely distant future possibilities, like retirement and grandchildren.

A few years ago, I never thought I’d live to retirement age, or that I’d see my children as adults. As cancer places itself further in my rearview mirror, I realize that I have as much of a chance at a future as anyone else. And this unexpected final pregnancy is a bizarre way of returning full circle from the start of my cancer journey almost six years ago. A way of regaining something that was lost and continuing to prove that, despite the odds, there is life beyond cancer. ❤️