Hi there, my name is Jess McDonald and I’m from New York. Normally when I tell someone I am from New York, they think NYC, but we actually live about 5 hours from Manhattan in a very rural area of the state referred to as the Finger Lakes, well known for our wine industry. My story starts on New Year’s Day 2018. I was home alone with my two children (then 3 and 8 months old) when I ran upstairs to put a bra on. I got to the first landing of our stairs and to this day, I have no real reason why, but I happened to touch the left side of my breast where I found a small hard lump and thought to myself “hmm, that wasn’t there before.” Since I had just had my son that April, I had recently had a breast exam in September where I had no abnormal findings and was sent on my way. After finding the lump I instantly panicked and sent a text to my husband, who had run out quickly. When he came home, I made him feel the lump just to make sure I wasn’t imagining it. He too felt the same lump I had felt, we both agreed the next day I would call my midwife. I like many women who have shared their story here was not expecting much to come from it. I was only 33 at the time, and had no family history of breast cancer.
The following day, I returned to work, went about my day, putting off the call. My husband texted me to ask if I had made an appointment. I decided I probably should get it out of the way so I called my midwife’s office. My midwife was unavailable, but another provider was able to get me in that afternoon. At the appointment, the provider suggested a quick breast exam to confirm there was a lump, when her exam led her to the area, her face instantly drained white, and our casual conversation turned, it was at that moment I knew in my heart something wasn’t right. She suggested I be seen for a mammogram and ultrasound as soon as possible and I was able to schedule an appointment the following day.
My ultrasound was determined to be suspicious and I was scheduled for a follow up biopsy. The day of my biopsy came and I met with Dr. O’Connell. She entered the room with so much energy, a thick English accent, and a striking resemblance to one of my husband’s aunts. I thought to myself, “maybe this will be all right!” Dr. O’Connell completed the biopsy and told me I would receive results in a few days. Those few days were hard, I returned to work, but I am pretty sure I just stared at my computer until my phone rang on January 11, 2018. Dr. O’Connell was short and to the point, she told me I had infiltrating ductal carcinoma, it was ER/PR+ Her2-. For whatever reason, I stayed calm throughout the call. She told me that it was highly treatable and gave me some sound advice that I carried throughout my treatment. She said, “whatever they ask you to do, you do it!” Dr. O’Connell asked me where I would like to receive treatment and I remember saying to her, “I have no idea, I don’t know anyone who has had breast cancer!” Dr. O’Connell referred me to the Pluta Cancer Center. At that point, I collected my things and left work. I drove straight home and spent what feels like an eternity on the phone making and receiving calls. In the 20 minutes it took me to get home from work, Pluta had already called me and started coordinating my appointments. By the end of the day, I had scheduled with my breast surgeon, Dr. Farkas, I had made arrangements to have a follow up MRI to ensure that cancer had not spread outside of the area we knew about and I had let my parents, siblings and in-laws know. I unfortunately was diagnosed on my sister’s birthday and had to share the news with her that day. Those few days following diagnosis were a whirlwind, I cried for a good 3 days straight. Waiting for the staging and progression of your disease is unbearable, so much fear and doubt can take over your mind. After a few days of feeling sorry for myself, I picked myself up and told myself whether I had 3 days to live or 30 years, I wasn’t going to spend another second mourning and was going to live my life as if I had never heard the words “You have cancer.”
Sometime in late January I met with Dr. Farkas at Pluta. Dr. Farkas was everything I needed and more to start my cancer journey, she was just a few years older than me, in fact if we grew up in the same town, we probably would have been in high school together. She was a ball of energy and sarcasm. She met me with a few curse words, a lot of humor and a very hilarious drawing of what my cancer looked like. The location and aggressiveness of my cancer prevented her from advising me to have a lumpectomy, the outcome of a lumpectomy would leave me looking like I was bit by a shark. I was okay with this as I had made my mind up as soon as I was diagnosed that I wanted a bilateral mastectomy. My first set of breasts were trying to kill me, why would I fight to keep them. Once that was out of the way, Dr. Farkas reviewed my options for implants or for a procedure called diep flap, this was a procedure where they would remove my own tissue to recreate my breasts. Because I had two children, stretch marks and a couple extra pounds from my pregnancy, I agreed that diep flap would be my best option. Dr. Farkas gave me the information for Dr. Vega and encouraged me to see him and get on his schedule for surgery. Dr. Farkas thought chemotherapy would likely be avoided and at most, I would require radiation after surgery. Because of my age and non-existent family history of breast cancer, she urged me to speak with a genetic counselor and opt for testing to rule out any predispositions. I left that appointment feeling hopeful.
I got home and scheduled an appointment with Dr. Vega and with the Genetics Department at UR Medicine. I met with Genetics and agreed to testing. My results were to be in anywhere from 1-4 weeks later. I met with Dr. Vega and he believed me to be a great candidate for diep flap as well as a nipple sparing procedure! By this time, we were fast approaching my son’s first birthday. Because I had chose the diep flap procedure, my recovery would be a bit longer due to the incision in my belly where they would take the tissue from. Not only would I be recovering from a bilateral mastectomy, but also a tummy tuck! Dr. Vega is one of the only providers in Rochester who was offering this procedure, so as you can imagine, his schedule was jam packed. When finalizing that I would be moving forward with this procedure, Dr. Vega requested I get on the schedule while I was sitting in his office, his nurse ran off to get the next available date and came back with March 29th, 11 days before my baby boy’s 1st birthday, I burst in to tears! Dr. Vega instantly recognized something was wrong and I explained that I had really hoped to be able to hold my son’s birthday cake. Dr. Vega’s team agreed this was absolutely necessary, so his team did everything in their power to get me a better date. This was no easy task as my surgery was expected to be no shorter than 6 hours, but they did it. They scheduled me for March 6th. I remember Dr. Vega saying, “You may want to order a small cake.” And guess what, you better believe I held that birthday cake!
As March 6th approached, the genetic testing fell to the back of my mind, I was operating under the assumption that “no news is good news.” I arrived at the hospital the day of my surgery and was met by Dr. Farkas, she quickly reviewed the procedure and then dropped the bomb on me, my test results were back, not only was I found to carry the BRCA2 mutation, but I also carry of the CHEK2 mutation. My anesthesiologist was there in the room with me when Dr. Farkas broke the news to me, to this day, I’m confident my anesthesiologist knocked me out immediately following the news as I don’t remember anything from that point on.
Twelve hours later, I woke in the recovery room and was transferred to my room where I would stay for 3 days to be monitored for tissue failure and blood clots. On the second day of my stay, Dr. Farkas came to let me know that they had removed somewhere around 38 lymph nodes and that only 1 tested positive. She also let me know my cancer was Stage 2b and that she had scheduled me to see an Oncologist, Dr. Huston. On the 3rd day, I was released home. I really only remember being in bed at home for a few days. I hated the pain meds, they made me feel spacey and lethargic, so I quit taking them and opted for regular OTC medications. I found that being upright and walking made me feel better than any of the medications.
My anticipated time home for the surgery was 8-10 weeks, I returned to work early after 5 weeks home. During those 5 weeks home, I learned that because of the BRCA mutation, the aggressiveness of the cancer and the lymph involvement, I would require chemotherapy after all. I received 8 rounds of treatment alternating every other week. I completed 4 rounds of AC and 4 rounds of Taxol. Chemo definitely wasn’t a walk in the park, but it also was nothing like I expected. I worked throughout treatment, only missing chemo days. I had this expectation that chemo was going to make me deathly ill, but it didn’t, I just felt tired and often had a really weird taste in my mouth. The hardest part of chemo was the fear of losing my hair, my hair has always been a part of my identity, one of my girlfriend’s often referred to it as my “Shakira hair.” By the time I started losing my hair, I was ready for it to go, what they don’t tell you about hair loss during chemo, or at least my experience with it is that my hair texture completing changed, it didn’t feel like mine at all, I was ready to shave it, so my husband and I decided to do just that somewhere between my 2nd and 3rd treatment of AC. I have been cutting my husband’s hair for years, and to have him return the favor was a laughable experience. I survived off my weekly, if not daily check in with Laura, I was one week ahead of her in treatment, so we often found comfort in exchanging words of encouragement and advice. The perk of being across the country from someone else going through treatment, is that their provider may make suggestions yours didn’t and vice versa. I also connected with two women close to home that had been diagnosed in their early 30’s and they were available 24/7 for all of my crazy questions, daily revelations, or just to have a good laugh about losing your hair.
Following chemo, I underwent 26 rounds of radiation. Because of the location of my tumor, I had to receive a specialized treatment, called deep inspiration breath hold. This threw a real wrench in my plan as I had hoped to do radiation close to home. There was only one treatment center in my area at the time that offered this treatment, and it was nearly a 50 mile trip each way. The drive albeit annoying, did serve as a quiet time for reflection. I drove myself to and from each treatment and returned to work immediately afterward. Working through treatment made me feel normal. I also conserved my time off from work so that I could spend it on things I wanted to do like vacationing at the beach.
Since wrapping my treatment, I have opted for additional follow up care that will hopefully decrease my risk for recurrence. I take a daily medication, Aromasin and am part of a drug study where I take an additional drug that could be the medication, Everolimus or a placebo. We are pretty confident that I am on the med as I am experiencing a lot of side effects. In December, I underwent a total laparoscopic hysterectomy to permanently shut down my estrogen production, this choice was a little extreme, but it was the right choice for me. On the day of my surgery, my husband again sat in the waiting room, like he had done so many times before during treatment and appointments. We looked forward to this day as it really signified the final stretch of what felt like a marathon of a year, as he waited patiently for me to recover, he sat near another husband, his wife was just starting her cancer journey, with my same surgery team. When my husband shared that story with me the next day, I couldn’t help to think just how far we had come. I say this a lot, and it might sound crazy, but cancer took a lot from me over the last year and a half, but it also gave me a new perspective on life, a few lifelong friends and the opportunity to share my story in the hopes that it helps someone else. If I can offer you any advice at all to get through this diagnosis, it’s this, find a provider that you feel comfortable with and let them take you by the hand and walk you through the next year. Next, grab hold of someone who has completed the journey before you, specifically someone that agrees to answer any question, no matter how ridiculous or what time of day you ask. Because you will have lots of questions and lots of doubts along the way. And there’s no one that knows that feeling better than a fellow survivor! And lastly, laugh a lot. I read once that cancer isn’t a “journey” like so many call it, it’s a nightmare, I’ve found that the only real way to get through it is with humor, a few good friends and wine, a lot of wine!