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What is precision medicine and why does it matter when treating Stage IV breast cancer?

If you’ve already heard of precision medicine, what you’ve read likely fell into one of two camps. One point of view: it’s our ticket to sci fi-style healthcare. On the flipside, it’s an interesting tool, but certainly not the healthcare revolution we’ve been hoping for.

It’s a complicated topic, and we’re just at the very beginning of understanding how precision medicine will change healthcare, and breast cancer treatment in particular. But we do know that the truth isn’t as black and white as Wired’s perspective vs. The Atlantic’s. So, here are four things you need to know about precision medicine, and why it’s especially relevant for metastatic patients.

It’s really about targeted treatments.

The key to precision medicine is data—when doctors can identify exactly what tumour markers are specifically causing someone’s cancer, it’s easier to develop a targeted treatment.

Under our current system, each disease has a “standard of care,” or treatment protocol that is determined by scientific studies and survival stats. (In oncology, each type, stage and grade of the tumor has a standard of care.) There’s a reason medicine works this way—it’s an evidence-based approach where treatments have been studied and proven to work for most people, most of the time. If that first-line treatment doesn’t work for you, there are second- and third-line options that are also based on stats and outcomes.

Precision treatments help make therapy more customized. Doctors can now analyze the genes found in a tumour to look for the mutations that can cause cancer and often prescribe drugs that target cells with that mutation, destroying them and leaving healthy cells alone. Women with stage IV HER2-positive breast cancer, for example, may be prescribed trastuzumab (Herceptin), which binds itself to the HER2 receptors in a tumor cell and blocks them from receiving growth signals, which then slows or even stops the tumor from growing.

When it comes to precision medicine research, breast cancer is one area of healthcare with lots of potential—but it’s still early days.

In the breast cancer world, genetic testing is familiar territory. We already know that women with BRCA1, BRCA2 or PALB2 mutations have a higher risk of developing breast cancer. And targeted treatments, like Herceptin, already exist. But while we’re already pretty far along compared to some other diseases, there’s still far to go. Researchers are currently trying to identify other mutations and, more importantly, the drugs that target them.

Instead, doctors may just need a blood test to determine exactly what medication a person’s cancer will respond to—and what it won’t. This doesn’t mean just fancy new targeted treatments, by the way. A genetic test might reveal that your cancer will respond best to chemotherapy, or a combination of chemo and a targeted drug.

Either way, time is one of a metastatic patient’s most valuable resources, and this approach has the potential to save a lot of time.

Some of the benefits (like progression-free survival and better quality of life) are particularly important for women with metastatic breast cancer.

Precision medicine won’t just improve survival rates for women with metastatic disease. In fact, in the short term, the benefits are likely to be incremental. But those small improvements include an important impact on quality of life, since patients won’t have to try treatments their cancer may or may not respond to—and similarly, won’t have to suffer through side effects for medication that may not.

This might seem like a small victory, but quality of life is particularly important for metastatic patients. They don’t have time to waste—they’re living with a disease that will shorten their lifespans and eventually kill them. But the hope is that targeted therapies can keep their health stable so their focus can stay where it belongs: on spending time with loved ones and their own emotional well-being.

But there’s a serious economic downside to precision medicine, and we have to address it before some women are excluded from the benefits.

Precision drugs are only part of the story, but they’re an important one. Some combination treatments, which combine targeted drugs and chemo, have shown really promising results — one study found pertuzumab (Perjeta), chemotherapy and trastuzumab can extend life by 16 months, a massive amount of time for women with metastatic breast cancer. It’s true: these drugs are expensive. Developing them costs a lot of money, as do the clinical trials that are necessary to get them approved for use in Canada. But to the women with metastatic breast cancer, to whom more time is so valuable, they are also worth the cost.

Up next: we delve into exactly why cancer drugs, from targeted therapies to traditional chemo, are so expensive.

 

On June 21st, 2017, Rethink partnered with Aphria to host our second annual Medical Cannabis and Cancer Care forum. If you weren’t able to join us, here’s what you missed. And, if you were there, here’s a recap! 


On June 21st it was all about medical cannabis and cancer care. There was a great turnout as people were eager to hear about the latest in medical cannabis information, research, and advocacy.

THE QUESTIONS:

How can medical cannabis help someone who is undergoing cancer treatment?

How can someone access medical cannabis in Canada?

Why is there so much stigma around medical cannabis use?

What needs to be done in terms of medical cannabis education for health care professionals and government agencies in Canada?

THE CONCLUSIONS:

Ultimately, it was concluded that there is still a lot to be done for medical cannabis research and education in Canada. Our panelists argued that without proper education as to what medical cannabis is and how it is beneficial, the stigma about its use cannot and will not be reduced.

But, in the mean time, we must continue to advocate and educate – focusing on the breakthroughs in research around medical cannabis and cancer care, as opposed to vilifying the plant because recreational use is not yet legal in Canada. Patients have the right to ask for a second opinion if their doctor refuses to suggest medical cannabis as part of their treatment plan. And, ultimately, as Canadian citizens, we “vote with our wallets” (Erin Prosk) by choosing to support trustworthy cannabis clinics/centres and raising the standard of care that they offer.

If you weren’t able to make it to the forum and you want to know more about medical cannabis and cancer care:

Check out the full recording of the forum on our Facebook page!

A BIG THANK YOU

Thank you to our amazing panelists, Dr. Vincent Maida, Lynda Balneaves, Erin Prosk, Beth Harris, and Julie Vickaryous. And thank you to Aphria for partnering with us in making this forum possible.

November 5 2009, 1:23 PM

I have a high tolerance for pain.  Anyone who knows me well – family members, doctors, estheticians – will confirm this.  My husband and I agree: I am tough. Not French Foreign Legion tough, but maybe Canadian Special Forces tough.

However, for the last 12 hours and, to a lesser extent, for 48 hours before that, I’ve been enduring wave after wave of intense abdominal pain. I emit weird primal noises and make fists and kick one foot around like a dog dreaming of chasing rabbits… And then the pain passes and, like a crazy person, I type some more.

It’s the drugs – my hitherto mild-mannered capecitabine and lapatinib are now mercilessly kicking my butt.  Causing stomach cramps, intestinal cramps, nasty, painful, crampity-cramps and no small measure of the trotskys…

If it were possible to be punched in the solar plexus and kneed in the nuts while in labour, that’s how I feel.

I have a hot water bottle pressed against my stomach at all times. My husband makes them so hot they have to be wrapped in gigantic towels for the first couple of hours. I may have poached my innards. Don’t care – the relief is glorious.

My mom is now here, taking over where my husband left off when he went to work this morning.  She has fed me mashed bananas and electrolytes and soda crackers. She is busy in the kitchen now – I can hear her over my own weird primal noises; the comforting sound of her clattering around down there.

Another wave is coming.  I really need to stop with the typing. Viva Imodium! Charge!

Name: Karen

Age: 27

Occupation: Recruitment Advisor

Age when diagnosed with breast cancer: 27

Breast cancer type: Breast Cancer, Hormone Positive/HER-2 positive

Breast cancer stage: IV, metastasized to bone

Treatment: Currently undergoing 9 months of chemo/adjuvant chemotherapy – then TBD

Tell us a fun fact about yourself that has nothing to do with cancer

I love painting! I don’t consider myself a Picasso by any means, but I have several of my paintings hanging in my apartment

What’s your go-to pick-me-up song?

There are quite a few – I have a specific “chemo vibes” playlist that I have on repeat the day before and the morning of chemo rounds. My favourite song on there is Tom Petty’s “Won’t Back Down”

Currently really digging Bruno Mars “What I Like” as well

How did you discover your breast cancer?

I felt the lump myself, and made an appointment right away. It was initially dismissed as an infection, but when antibiotics didn’t do anything and the lump continued to grow rapidly I went back and went through the ultrasound/mammogram/biopsy process.

What went through your head when you received your diagnosis?

I immediately thought about my family and friends – how was I going to tell them? What did this mean for me? How much of my life was I going to miss out on?

What’s the craziest thing someone said to you after being diagnosed with breast cancer?

“At least it’s breast cancer and not something worse” and also “Well, you’re going to get a new pair of boobs!”

Who or what is/was your biggest source of support throughout your experience with cancer?

My family and friends. I have been absolutely blessed with an amazing group of people in my life who have really rallied around me, especially in times of need.

What is/was the most difficult part of being a young woman with breast cancer?

Dating/relationships. It’s hard enough to navigate the dating scene anyway, let alone when you have a diagnoses like cancer, how do you let someone know? Is it fair to bring them into this situation?

What’s something unexpected you learned about yourself as a result of having breast cancer?

That I’m capable of pushing through what seems like the darkest days and continue to be positive and happy – I’ve learned to appreciate what’s important in life and to be grateful for what I do have.

In one sentence, what words of wisdom would you pass on to another young woman who has just been diagnosed with breast cancer?

The diagnosis makes it feel like the world is crashing down all around you, and you don’t know how you’ll ever make it out of the rubble – but fight, fight hard one day at a time. Pull your army in close, educate, and advocate for yourself. Sometimes it can feel like the diagnosis has taken over, and you’re just a shadow of your old self, but don’t let that happen – you’re still YOU!


 

For more #YWMBC profiles click here.

Name: Rose Anne Crisostomo

Age: 39

Occupation: Human Resources Manager

Age when diagnosed with breast cancer: 36

Breast cancer type: Invasive Ductal Carcinoma

Breast cancer stage: Stage 2 (estrogen and progesterone positive), BRCA 2 POSITIVE.

Treatment: Six rounds of Chemo, 25 rounds of Radiation, Surgery ( which included a double mastectomy, fat grafting, expanders, and nipple tattoo)

Tell us a fun fact about yourself that has nothing to do with cancer

When I was little most girls played teacher, I played lawyer. I asked my mom to buy me files, paper and pens and I would draft up divorce papers.

What’s your go-to pick-me-up song?

Happy by Pharrell Williams

How did you discover your breast cancer?

I was 24 weeks pregnant at the time, and noticed a big hard lump on my right breast, as it was my first pregnancy I thought it was a clogged milk duct.

What went through your head when you received your diagnosis?

I went numb. I did not cry until later that day, but I started to think, what’s going to happen to me?, what’s going to happen to my unborn child?, what about my family and friends?

What’s the craziest thing someone said to you after being diagnosed with breast cancer?

If it was going to happen to anyone it would be you, your mentally stronger than I am. (my thoughts were….did she just really say that to me?????) Ignorance is bliss I guess.

Who or what is/was your biggest source of support throughout your experience with cancer?

I would not have made it without the help of my mom, who moved in with us for seven months (just after I was diagnosed with cancer) and took care of me, my husband and ultimately little Benjamin. At 72 years young, she stepped up to the plate and looked after us all. Through emotions, exhaustion, and never ending work of looking after a newborn, she was my rock, and my very best friend. Of course my husband as well, he was there for me at my lowest points, your know your marriage is strong when he has the strength to shave his wife’s head.

What is/was the most difficult part of being a young woman with breast cancer?

I think the unknown. You live your life day by day, but you really don’t know what the future has in store for you. You will always be nervous when you have to do routine blood work, and annual check ups. Neither my fight nor my journey is over, but I’m hopefully the worst is behind me.

What’s something unexpected you learned about yourself as a result of having breast cancer?

I am stronger than I was before, and even though I’m not always confident, I know I am a fighter. I’m happy, and blessed to be alive.

In one sentence, what words of wisdom would you pass on to another young woman who has just been diagnosed with breast cancer?

Fight like crazy to get your life back because after all that’s what you’re fighting for: your life.

…………………………..

For more #YWBC profiles click here or to be featured contact Shawna@Rethinkbreastcancer.com

October 15 2009, 12:04 pm

You know what I usually do when something really upsets me? I usually sit down on my kitchen floor and cry. It’s not the most comfortable place to cry (that would be my husband’s arms) but I often end up there. I seem to have a need to get low to the ground. Get terra firma (or kitchen tile) under me so I don’t wobble and break like a teacup.

I tell you this because I recently spent some time on my kitchen floor, right after reading this story in the Ottawa Citizen, which talks about a new program for young women with HER-2 positive breast cancer. “Sounds great,” I thought. “Maybe I’ll get involved,” thought I.

And there, smack in the middle of the article was this line:

“…it’s easy to see why HER2 is so feared: In a study last year at the University of Texas, women with early stage HER2-positive tumours were reported to have a 23-per-cent survival rate, compared with 90 per cent for breast cancer patients who do not test positive for the protein.”

Plop – straight to the floor. Tears (big fat ones) and terror (also robust) ensued. How dare they?  How dare they just hit me with that 23% when I really and truly believed that I would beat this?  Believed it to the point that I publicly chastised anyone who didn’t believe it.  I more than believed it – I was full of conviction; I knew I would beat it.  And then, one little line in one little article sends me to the kitchen floor, my conviction shattered and my mascara all over the place??

Yes, actually. That’s all it took. Suddenly I was aware that my steely resolve and hell-bent determination are a little more fragile than I realized.

Slowly, the fatso tears became little spatters and then stopped altogether and reason – or my version of it — took over. I concluded that deeming the University of Texas researchers a bunch of hacks was appropriate. As was feeling very unkindly toward the reporter who included that line in her story. Thanks a lot, stupid no-cancer-having lady, for your blithe reference to these death stats concerning something I have to live with every day. Why don’t you go back to writing about five great picnic spots in our nation’s capital and leave me to my shattered optimism.

There – being nasty made me feel better already. Next I went into action mode, pouring myself a nice big glass of wine and Googling all the statistics for various kinds of death, thinking surely it’s harder to survive car accidents and parasitic infections?

That’s when I found a story about that crocodile hunter guy. Yes, the crocodile hunter guy. I know this sounds completely irrelevant, but stay with me: There he was, Steve Irwin, cheerfully bounding around swamps and wrestling dangerous reptiles one day – then suddenly pierced through the ticker by a normally gentle sea creature the next.  He didn’t know what was going to happen to him when he went into the reef that day.  He probably had fewer reservations about swimming with those big portobello mushrooms than he would ever have had about hanging out in croc-infested swamps — and you can bet the stats for crocodile deaths are much higher than for death-by-sting-ray.

Which is when I realized that statistics are for morons. In reality, you can never know when or how you’ll die, you can only choose how you’ll live. Some people wrestle reptiles, some wrestle cancer.  In the end, the obvious danger may not be the thing that strikes you down.  After all, that’s why I still wear a bicycle helmet.

So, thank-you dearly departed crocodile guy – I bet you never thought you’d come to the rescue of a Canadian girl with HER-2 positive cancer. Life is full of surprises, and stupid statistics abound, but I am going to live. This cancer is not going to win. I knew I cracked open the Australian wine for a reason.

Tomorrow April 7th is World Health Day: A global health awareness day sponsored by The World Health Organization (WHO). This year’s focus is mental health. It is interesting to me that the World Health Organization has chosen this topic for their campaign this year. Surely there are other more important health crisis across the globe that trump (no pun intended) depression and mental health? Or are there?

According to a press release put out by WHO in March:

Depression is the leading cause of ill health and disability worldwide. According to the latest estimates from WHO, more than 300 million people are now living with depression, an increase of more than 18% between 2005 and 2015. Lack of support for people with mental disorders, coupled with a fear of stigma, prevent many from accessing the treatment they need to live healthy, productive lives.

They go on to say that they have identified strong links between depression and “non-communicable disorders and diseases” meaning that people with, let’s say… CANCER have a higher risk of depression.

This is a huge acknowledgement in the psychosocial oncology world and one that people diagnosed with cancer need to be aware of. I have heard one too many times from women with earlier stage breast cancer that once treatment is over they felt like they were hit with a title wave of sadness and grief. These two questions linger once the dust settles:

What the F*%k just happened?

Followed by….

Why don’t I feel relieved and happy to be finished with that part of my life?

No cancer equals all better

There is a clear expectation that if you look good you feel better. There is even a program based on this assumption. Just because someone doesn’t look ill or the poster image of a cancer patient doesn’t mean that they are completely healed. There are often lingering physical and emotional side-effects (laundry list here), post-treatment or adjuvant therapies like Tamoxifen and the biggie – recovering from trauma.

Note: Those with metastatic or stage 4 cancer often experience some form of depression or anxiety that requires treatment. They are in perpetual fear and anxiety as they are scanned every 3-4 months.

Many people have heard of Post Traumatic Stress Disorder (PTSD) when it comes to war or an act of violence, but often people don’t think of a cancer diagnosis as the cause of that kind of extreme stress. I am not sure if this belief comes from some sort of normalization of cancer in our society (the “everyone gets cancer” attitude) or maybe it is a belief that cancer is curable? A diagnosis can and does cause some people such extreme stress that 1/3 of people with cancer experience anxiety disorders or depression. That’s 32% of cancer patients according to a study published in The Journal of Clinical Oncology in 2013.

Let me break down some examples of cancer related trauma:

Being diagnosed with the disease

THOUGHT: I may die.

Diagnosis of an advanced cancer

THOUGHT: This disease is incurable and I will die from it.

Painful tests and treatments

THOUGHT: People are poking and prodding me. My body is not my own.

Pain from the cancer itself or other physical issues

THOUGHT: I feel pain and my body is never going to feel the same.

Test results

THOUGHT: The cancer has progressed and attacked other parts of my body.

Long hospital stays or treatments

THOUGHT: I am in a place with sick people. I am a sick person. I am a cancer patient.

A cancer recurrence or the potential for recurrence

THOUGHT: I might get cancer again and there is nothing I can do to stop it or control it. I am at the mercy of this disease.

Often people don’t know they are experiencing any type of cancer related mental health issue until they are there, and they can sometimes feel quite shocked and ashamed. There can be feelings of guilt – you should be feeling grateful or “lucky” that you made it through and your body is showing no evidence of disease. Or you may feel pressure to be happy and to move on from the experience but you can’t.

Being Prepared

I know I say it a lot but I am going to say it again…wait for it…Knowledge is power! Especially when you are blind-sided by feelings that seem antithetical to what you think you are supposed to feel. We hear this with post-partum depression a lot. Here you are – you just had a baby. The joy and happiness you are supposed to be feeling is clouded by anxiety, fear and sadness. No one prepared you for this. You always wanted to be a mother and you always heard this is supposed to be the happiest moment of your life. And then it’s not.

I had post-partum depression and I remember desperately wishing someone had told me or warned me this might happen. Wishing I had the heads up and was prepared so that it was less scary and frightening when it came so that I could be pro-active and put supports and measures in place just in case…and I did with my second child.

It is important that those diagnosed with cancer are prepared in a similar way. While referrals are often made to psychosocial oncology resources DURING treatment, patients are left holding the proverbial bag after treatment. Many are not aware these support services are accessible once their hospital treatment is over, and most initially feel like maybe they don’t need them. This can leave you scrambling in your darkest hour when you are most vulnerable.

As mental health continues to get more and more attention as a health epidemic, it is important that we start with educating our most vulnerable populations. Healthcare providers need to acknowledge risk factors pre-emptively before it becomes a crisis so that those who are at risk can feel empowered to speak up if and when the time comes. They can also arm patients with tools and resources to determine whether they need help and where to go to get it.

The Check-List

The following is a great list from Cancer.net.

If you are experiencing the following, it’s time to follow up!

Mood-related symptoms

  • Feeling down
  • Feeling sad
  • Feeling hopeless
  • Feeling irritable
  • Feeling numb
  • Feeling worthless

Behavioral symptoms

  • Loss of interest in activities that you previously enjoyed
  • Frequent crying
  • Withdrawal from friends or family
  • Loss of motivation to do daily activities

Cognitive symptoms

  • Decreased ability to concentrate
  • Difficulty making decisions
  • Memory problems
  • Negative thoughts. In extreme situations, these may include thoughts that life is not worth living or thoughts of hurting yourself.

Physical symptoms

  • Fatigue
  • Appetite loss
  • Insomnia, which is the inability to fall asleep and stay asleep
  • Hypersomnia (excessive sleepiness)
  • Sexual problems, such as decreased sexual desire

Note: The cognitive and physical symptoms listed above may be side effects of the cancer or cancer treatment. As a result, doctors place more emphasis on mood-related and behavior symptoms when diagnosing depression in a person with cancer.

Psychosocial-banner

For more on the Psychosocial click HERE!

Date: April 26

I’m feeling: Claustrophobic

LAST NIGHT WAS A NIGHTMARE. I am completely frustrated. I want to rip these damn drains out of me because they feel so uncomfortable. I want it to be a year from
now. I want to be settled and find a new place so  I can get back into a routine, so I can stop forgetting everything and remember what is going on in my friends’ lives. I want to start my career. I just want some damn sleep. LAST NIGHT WAS A NIGHTMARE.

October 14th 2009, 10:29am

I just had another bone scan. I like the bone scan, as I have mentioned before, repeatedly, and to anyone who will listen. I just happen to think it’s amazing to see my whole skeleton on the computer screen. Really, who ever gets to see every bone in their body, from head to toe(s)? I think it’s totally fascinating. Not to mention rather seasonal, what with Halloween right around the corner.

For the uninitiated, the bone scan takes place in the terrifyingly named Nuclear Medicine Lab, and involves getting an injection of tracer fluid, which comes in a lead tube with this symbol all over it:

radioactive 2

I never tire of saying that they give me this radioactive injection “just in case I don’t already have cancer,” and today I thought it would be funny to say it to the lab technicians handling the injection. They didn’t laugh. They looked at me and blinked and kept doing their thing.  Clearly they’re not so much into cancer humour down there in the ol’ Nuke Lab.

Actually, for all the Chernobylesque weirdness of it, the needle is tiny and doesn’t hurt at all.  The fluid travels through the blood stream to the kidneys and into the bones, which then magically light up onscreen when they slide you through the giant George Foreman Grill type apparatus. This takes about twenty minutes.

Painless, fascinating, and effective for diagnosing any trouble cancer might be causing in dem bones. What’s not to love about this test?

Also, I make a nice nightlight for a few days.

Not true, I just wrote that to irritate the lab techs. But if I were to have to fly somewhere in the next couple of days, I would set off the security alarms at the airport. For this purpose, you can get a special post-scan medical card that says that you are not a bomb (not in so many words.)

Here are some things I learned today:

  • An x-ray looks at the anatomy of bones whereas a bone scan looks at the physiology.  In other words, an x-ray knows what my bones look like, and a bone scan knows what they’re doing.
  • With an x-ray, the radiation comes from the machine, whereas with a bone scan the radiation comes from you. And you were worried about standing in front of the microwave.
  • Because the radioactive tracer fluid goes through the kidneys into the bones and is then expelled through urine, all you’ll see in the imaging is bones, and sometimes kidney and bladder, which show up as black spots. This is very important to remember since when people with caner see any kind of black dots whatsoever on medical imaging they tend to freak right out.

Coming soon: the actual scan images of my skeleton…  Hoping to pick them up from the hospital records desk in time for my Halloween post!  Spooky!

Name: Adriana Capozzi

Age: 37

Occupation: Hairstylist… currently a stay at home mom of three.

Age when diagnosed with breast cancer: 35 Breast cancer type: er- pr- her2+

Breast cancer stage: Originally stage 3, Now Stage 4 Metastatic breast cancer to my brain.

Treatment: I had day surgery to have a port put into my chest. I had 8 rounds of Chemo every second week. During my last 4, I began Herceptin every 3 weeks for 12 months. I had a bi lateral Mastectomy, followed by 25 rounds of radiation. I have had stereotactic radiation to my brain – a Crainotomy followed by targeted brain radiation.

Tell us a fun fact about yourself that has nothing to do with cancer

I LOVE to travel! Before I was married with children I used to travel a few times a year. I always traveled alone, I loved the excitement I felt entering the airport, not knowing who I would meet or where I would stay. I took a year off and traveled around Southeast Asia and Australia alone. I bought a one way ticket and that’s it! It was an amazing year of finding myself, and stepping out of my comfort zone.

What’s your go-to pick-me-up song?

Right now I’m liking Alessia Cara… Scars to your beautiful is currently a strength song for me. I also love  Lost Boys by Ruth B.

How did you discover your breast Cancer?

I found a lump one day while getting dressed. I remember my heart sinking and i instantly knew it wasn’t right. I went immediately to the drs and was sent for an ultrasound. They told me it wasn’t breast cancer. Three months later I had another follow up and found out the lump was cancer. What went through your head when you received your diagnosis? When they gave me the news, I already knew it in my heart. I remember walking out of the ultra sound and the technicians giving me the sad look. I was devastated. I remember thinking it had to be wrong. I was pregnant with twins and I was terrified what it all meant.

What’s the craziest thing someone said to you after being diagnosed with breast cancer?

Oh gosh, there are a few! People often say to me, “ but you don’t look sick.” “ at least you get a boob job.’’ “ but your gaining weight?”

Who or what is/was your biggest source of support throughout your experience with cancer?

Support is something I have struggled with. I have a wonderful husband and wonderful children, that have always been there for me and by my side, but I have to say I have found the most support from women in my situation all around the world ( online fb groups) They understand my feelings, and can always give me some insight to what worked for them.

What is/was the most difficult part of being a young woman with breast cancer?

For me, being metastatic, I find it extremely hard fitting in. I don’t look sick, but I am. I have three young children ( 3,4,7) and I have an extremely hard time living in the future. Hearing everyone around me plan for the year ahead is hard. I’m learning to live in the now, and enjoy today.

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What’s something unexpected you learned about yourself as a result of having breast cancer?

I am a lot stronger mentally than I ever thought. Sometimes I wonder how I’m not siting in bed crying all day. Its been a long, hard two years. My mind is powerful, and I have learnt how to embrace the sad, and then throw it away and move forward. It took me some time but I am in a great place now.

In one sentence, what words of wisdom would you pass on to another young woman who has just been diagnosed with breast cancer?

Live in Today, worrying about tomorrow won’t change anything, cry when you feel sad, give yourself that, but don’t let cancer take away who you are, and all the happiness around you.

……………………………..

For more #YWMBC profiles click here.