Desiree is our model for our 2005 Cabernet Syrah.

The battle had begun.

Desiree was methodical about having an annual mammogram, making it an every 12-month ritual. Except this time. She was overextended with work and graduate school such that this mammogram was not completed until 18 months after the previous test. Desiree visited a prominent cancer center for the exam and test. As she was waiting for the technician to view her films, a radiologist appeared and advised her that they would like to perform an ultrasound immediately. While the radiologist (and an oncology surgeon) was viewing the ultrasound results, the radiologist announced: “You have breast cancer.”

“I was stunned, in shock, and in a complete daze,” notes Desiree.

Two weeks later, Desiree underwent a very painful biopsy. “It was a core and fine needle aspiration of which she felt every extraction of the needle -- in spite of the local anesthetic,” she says. “There are different types of biopsies and patients should learn about their options.” The biopsy procedures revealed the presence of cancer.

Desiree then met with the surgeon. “In his mind it was simply a matter of which surgery – mastectomy or lumpectomy; he provided me with a few sketchy details and expected my decision on the spot. During this examination and meeting, the surgeon never made eye contact with me. When I asked for more information on the procedures, he wanted to know exactly ‘how much detail I would require’. Needless to say, I considered this, an extremely sarcastic and insensitive response. At this point, I was still researching my options, but the vast amount of information was overwhelming. I really had very little opportunity to absorb the research as I was trying to cope with my emotions in a rational way and make a decision about my future, while attempting to hold the rest of my life together. “

On the advice of a good friend, Desiree sought a second opinion at the City of Hope Medical Center. “My experience there was the absolute antithesis of my previous one,” she offers. “My surgeon, Dr. Shen, could not have been more considerate and helpful. She spent almost two hours explaining the diagnosis, the different types of breast cancer, and numerous treatments (new and conventional) and discussed my next steps. All of this afforded me time to conduct more research and ask further questions. She also discussed her background (she completed a Breast Surgical Oncology fellowship at the University of Texas, M. D. Anderson Cancer Center in Houston where she received training in the surgical management of breast cancer, in addition to medical oncology, radiation oncology, radiology, pathology, plastic reconstructive surgery, breast cancer screening and prevention, and the management of high-risk patients). I absolutely love my surgeon! She’s, energetic, intellectual, compassionate and interested in cutting edge research. Best of all, her practice is 100% focused on breast cancer. She is not a general surgical oncologist who performs all types of cancer surgeries. Thus, I felt secure that she was knowledgeable about the latest studies and techniques and, moreover, that she was not jaded; I didn’t feel like a number on an assembly line.”

Desiree’s diagnosis was complicated by the fact that she has Lupus. Her doctors were concerned that a lumpectomy plus radiation option would have a detrimental effect at the cellular, subcutaneous level which might impact the resiliency of her skin or aggravate other organs – considerations never entertained by the first surgeon. The City of Hope team met several times in a patient review board to agree upon the best course of treatment to recommend. “Their process made sense to me. The board consisted of my surgeon, my oncologist, my radiologist and a plastic surgeon. So all of my current and future cancer physicians were able to confer together to coordinate a treatment plan. I had confidence that I was in really good hands.”

After careful consideration and much thought, Desiree decided to have a mastectomy, believing that she had the best possible chance to eradicate the cancer with this surgery and hopefully avoid undergoing radiation treatment after the mastectomy.

“My surgeon performed a beautiful skin-sparing mastectomy in order to provide me with extra tissue that could be used in the event of future reconstruction. The mastectomy gets complimented by almost every physician that sees it as well as other cancer survivors.”

During her surgery it was determined (with a sentinel node dissection) that her cancer had spread to the lymph nodes. Consequently, the surgeon performed a mastectomy and removed 26 lymph nodes, 8 of which were cancerous.

Desiree’s oncologist recommended chemotherapy followed by Herceptin and radiation therapy. Her cancer was staged Phase III-B.

Desiree underwent four rounds (every two weeks) of a dose dense of Adriamyacin and Cytoxin, followed by Taxol and Herception for 12 weeks. Adriamyacin, Cytoxin and Taxol are three different types of chemotherapy. Herceptin was administered for a total of 12 months. “The side effects of these treatments were plentiful. “I lost my hair; my hands and feet turned black, and my nails and toenails were damaged due to neuropathy. I had little energy, but was able to work a good part of the time. I also gained way too much weight. I experienced chemo fog and countless other symptoms, but I was never hospitalized during the treatment. I also ingested lots of other drugs along with the chemotherapy (and the Herceptin which is administered intravenously). I needed these other drugs to boost my blood count and immune system, the steroids and anti-emetics were used to combat the chemotherapy side effects. During this time, I was very focused on my nutrition and general health. The18 months of medical treatments was daunting, to say the least. No matter how difficult and painful, I kept my eye on the prize, thinking I can get through this too; it is just another of life’s obstacle to overcome.”

Chemotherapy began for Desiree in October of 2005 and was completed in February of 2006. In March 2006 she started radiation therapy. After six weeks of daily radiation visits, that treatment was completed by the end of April. The Herceptin treatment continued through the end of December 2006. I currently take an aromatase inhibitor (rather than Tamoxifen) – Aromasin daily. This is a drug helps block the creation of estrogen which can increase cancer growth rates.”

“I have not had reconstructive surgery. Like the Phoenix, I feel that I have risen from the ashes; now is the time for healing my body and my soul. I’m not sure if I am ready for another 12 months of surgeries and medical procedures. I chose not to have reconstruction at the time of surgery because the plastic surgeon at the City of Hope have observed that optimum cosmetic results are obtained (when radiation is involved) if the skin is allowed approximately 18 months after surgery and at least 12 months after radiation to heal.

Through it all, Desiree was focused on living. “When I first heard those words, ‘You have cancer,’ I thought it was a death sentence. I remember driving home and thinking ‘I’m glad we took care of our estate planning.’ Funny, I’m practical that way. I didn’t know much about the disease and felt that I needed more information. Unfortunately, the radiologist “diagnosed” me prior to performing the biopsy, so I didn’t have much time to even consider the possibility that I might (or might not) have cancer; it seemed to be a foregone conclusion.

Desiree emphasizes that having the best medical team available can help to lessen the stress and worry. “The first cancer center I went to was located at a large research university. I felt like I was part of an assembly line. The nurses, administrative staff and the oncology surgeon were indifferent to me. The radiologist was somewhat compassionate – at least I initially thought so, but then I felt I was being rushed through the process; that it was more about processing new business than taking care of me. On the day of my biopsy I had to spend a significant amount of time in the business office. By that time, I was so overwhelmed with the idea of having breast cancer that I was really just going through the motions. I had shut down by then – I refer to it as going ‘underground’ - a place where nothing really affects me, at least on the surface.”

Support was ample for Desiree. “I turned to my life partner, Arlene, who became one of my main sources of breast cancer education as well as emotional support. I also turned to the medical staff at the one of the best certified cancer research centers in the world, City of Hope. I was very fortunate to have my family of friends, three of whom are physicians, to provide lots of support. We were conferring almost daily as everyone wanted to be kept informed; I felt very loved and cherished. A vast array of resources exist which also helped me. Live Strong, Lance Armstrong’s Survivorship Notebook was wonderful. I had a terrific weekly support group that I attended (The Wellness Community)– I wish I had discovered it earlier in my journey. Dr. Susan Love’s Breast Book was very valuable. The Write Track was a journal that I used for keeping my medical information organized. It was my lifeline.”

Desiree discovered that she had lots of fight in her. “After my first meeting with the surgeon whom I selected to perform the mastectomy, I knew I had a chance. She was extremely bullish about survival; I knew then that this was not a death sentence. I simply had to get the best possible medical care and then avail myself of every possible alternative that was available to fight cancer.”

Fighting turned to winning for Desiree. “When asked the question: When did you know that you were going to live? She responds: “Well, that really is the crux of the matter isn’t it? Coming from an extremely disadvantaged background, I have always had to surmount untold obstacles – just to live really. I am accustomed to battling for my life in a myriad of circumstances so I already had a “warrior” mentality. It was a natural response for me to simply enter the fray without a second thought. There never was a ‘can I do this?’ option for me. I fight the battles whether I will win or not, because that is what provides me the best opportunity for survival. I can’t be complacent. That would place me at risk. I must always be vigilant and prepared for Plan B; I always know that in order to win, I must be present and engaged in this struggle for my life. So the question – “when did I know I was going to win?” Really, I didn’t (don’t) know that, but I knew that my focus would be to create the best opportunities to do so.”

Desiree is still actively directing her healing process. “I continue to educate myself about this complicated and pernicious disease. I am just as vigilant about my medical appointments as I was when I was in adjuvant treatment. I am cognizant of my nutritional needs and, also, about the importance of exercise. One thing I do know is that it is crucial to take care of my emotional needs as well as the physiological ones. I’m not sure that I have completely processed the recent experience or the meaning of the next stage of the journey. There is also the specter of my breast reconstruction; I have been struggling with this – the idea of facing another year, at least, of surgeries and more medical procedures is disheartening.”

Sharing her experiences with others diagnosed with breast cancer is important to Desiree. “Having completed my most aggressive treatment in December 2006, I have really taken the last six months to adjust to the next stage of my life; to what it means to be a survivor. Initially I didn’t have the emotional resources to do much; it was vital that I resume my life; that took a lot of courage and stamina. I have offered my written story to friends and friends of friends who have been recently diagnosed. I have also registered as a support person with Living Beyond Breast Cancer, an organization devoted to just that. Finally, I am participating in a nationwide study to assess the quality of life after breast cancer for women of color. My crystal ball, however, tells me there will be more outreach in my near future.”

About Desiree E.

Desiree E. is a native of Oakland, CA. She and her partner live is Los Angeles where she enjoys a successful career as a real estate economic consultant. She is an avid reader, enjoys fine wine and food, and sees her friends as one of the greatest joy in her life. She also gets pleasure from walking, hiking, and travel.

The One Take Away Item: Join a Support Group Early On. “Regardless of the love and support of family, friends and medical providers, NO ONE can understand the breast cancer experience better than another survivor or someone who is experiencing the process at essentially the same time. The amount of medical information that was discussed at group meetings was crucial; it would have helped me significantly to have this information while making decisions about treatment options... The support group also helped me to understand the impact of the treatments I was receiving and, more importantly, how to take care of myself during the process.”