Jesseca: Breast Cancer
Jesseca has had many small non-cancerous lumps (adenomas) in her breasts, so she was used to going to Smilow Cancer Hospital to be monitored every six months with mammograms and ultrasound tests. When she felt a lump in her left breast in November 2013, she fully expected to be told she had another adenoma. But this time, the radiologist told her something different. She needed a biopsy. Difficult news came back … she had aggressive Stage IIA cancer.
Jesseca spent a tortured week worrying before her scheduled appointment with Brigid Killelea, MD, Assistant Professor of Surgery at The Breast Center at Smilow Cancer Hospital.
“The lump, which was about the size of a quarter when I first felt it, had ‘exploded’ during the week after the biopsy, filling the whole left side of my breast,” recalled Jesseca. “Dr. Killelea told me to stop taking the hormone that had been prescribed to block my endometriosis symptoms. Apparently it was feeding the cancer. Two days later, I saw Dr. Pusztai, an oncologist at Smilow who talked with me about taking part in a clinical trial, in which I would have chemotherapy to shrink the tumor before I had surgery.”
Lajos Pusztai, MD, Chief of Breast Medical Oncology and Co-director of the Yale Center Center’s Genetics and Genomics Research Program, is principal investigator of several clinical trials that are studying new drugs and identifying ways to select the best treatment for each patient.
“The word ‘trial’ itself makes everybody nervous,” notes Jesseca. “Dr. Pusztai told me the clinical trial would give me a 90 percent chance of the cancer being killed before surgery versus a 60 percent chance if I had the standard treatment, so there was no question in my mind that I should choose the clinical trial. It was a no brainer. Sure there would be side effects. I understood the drugs might cause heart damage, but having this treatment was more important to me. If my cancer got worse, I wouldn’t be here to worry about heart problems.”
Clinical trials are designed to answer questions about new ways to treat cancer and are an option for many cancer patients. Each trial follows a specific protocol, which explains what the trial will do, how the study will be carried out and why each part of the study is necessary. Many of the treatments being used today are the result of past clinical trials.
Jesseca started her treatment shortly after. Her protocol called for 12 weekly treatments with chemotherapy drugs, each lasting anywhere from five to ten hours, depending on the number of drugs being used. She suffered side effects – her hair fell out, she had extremely dry skin and rashes, as well as nausea. But she also saw results.
“The tumor started shrinking,” said Jesseca, “so I had physical confirmation that the chemo was working. That really helped me. It made me feel like all the suffering was worth it.”
Jesseca had a second set of chemotherapy treatments, this time every three weeks for 12 weeks. She suffered more side effects, but the tumor kept shrinking. “I finally couldn’t feel the lump at all, but the doctor told me that all the cancer hadn’t been killed before surgery. In June, I had my lumpectomy, followed by 33 radiation treatments.
“Then I was enrolled in another clinical trial as a preventive measure,” said Jesseca. “I was scheduled for a treatment one week out of every three for ten months. I received the first treatment but became extremely ill. Only one other patient had been treated at Yale on this trial and there wasn’t enough data available on what to do for symptoms. So I decided not to continue. But I didn’t want to portray the attitude that I was afraid. I was nervous that the doctors and nurses would be upset with me if I didn’t remain on the trial. Obviously they weren’t. Continuing on the trial just was not right for me at that point. I am presently being treated with Herceptin, which I am scheduled to do through December, to reduce the risk of my cancer coming back.”
“The nurses and doctors at Smilow, and the care I received there, have been excellent. The infusion nurses are awesome … I don’t know how they do that work day in and day out. Everybody responded to my phone calls. And the three times I had to go to the emergency room, the staff worked so quickly and made sure I got the treatment I needed,” said Jesseca.
Prayer has played an important part in helping Jesseca cope. “In the very beginning right after I was diagnosed,” she noted, “I was told it would be a week and a half before I could get an appointment with a doctor. My stepbrother called me, he was in Jordan, and we prayed together about getting answers more quickly. And I was able to get an earlier appointment with Dr. Killelea. My family always had more faith than me, but this was the first time I had seen prayer result in a physical action. It opened my eyes to the power of prayer, in having the faith to believe. My family lives pretty much all over the country so I’m alone here, except for my husband. I am lucky that I have a husband who is a great support for me. Definitely having my husband’s support has been essential. Even though I’ve learned that I’m a heck of a lot stronger than I thought I was, I wouldn’t have made it without him.”
“My advice to other patients is to stay positive. Ignore the petty little day-to-day stuff. Concentrate on today and be thankful for this time, right now, because that’s all you have. Try to find something positive to focus on, whether it’s the bird outside your window or whatever. Live one day or one hour or one minute at a time. It’s hard to do. You have to center your thoughts.”
“I also encourage other patients to try clinical trials. I definitely would recommend that they fully listen to what the nurses and the clinical trials people tell them so that they can make the best decision, a decision that’s right for them. I’m very open to doing another clinical trial if I need to,” said Jesseca. “Looking back, I know I asked the right questions and made the right choices along the way.”