Nicole Names knew that it was very likely that she would get cancer. Both her mother and her grandmother were breast cancer survivors, and her first cousin had been recently diagnosed with breast cancer. While she expected to get cancer, she certainly did not expect to get it so early.
Because of her family history, Nicole received her first mammogram at 28. The results looked fine, and five years later she planned to repeat the test. As that date approached,
Dr. Margaret Mickelson, a board-certified obstetrician and gynecologist, told Nicole about a gene testing program the MeritCare Roger Maris Cancer Center offered that checked for hereditary cancer markers. Nicole enthusiastically agreed to be tested.
The Journey Begins
Nicole was referred to
Dr. Carol Grimm, an expert in breast cancer detection and risk assessment. Nicole recalls her first meeting with Dr. Grimm, "We talked about my family history, and I said, 'I am resigned to the fact that I will probably have cancer.' She said, 'Let's not put the cart before the horse.'" Within seconds of starting the exam, Dr. Grimm said, "'Have you ever felt this lump before?'"
Nicole recalls, "If you find the lump yourself, you have time to get scared. I had nothing before this meeting, so it was like a bomb dropped." Rather than complete the genetic test, Nicole had a mammogram. What showed up was a one centimeter mass, so Dr. Grimm immediately ordered an ultrasound that also showed the mass.
The very next day Nicole had a biopsy. Nicole says, "I thought I could leave work, have the biopsy, and go back to work. They told me I couldn't go back to work or lift anything over five pounds. That's when I got scared and it all hit me."
When the biopsy results came in, Nicole got a call from Dr. Grimm and learned she had invasive ductal carcinoma—the most common breast cancer, representing the majority of cases. "Literally, I felt that slow motion thing — it was so traumatic," Nicole says.
Step One
Nancy Anderson, the breast cancer nurse care coordinator, called Nicole after her diagnosis. A breast cancer diagnosis at the MeritCare Roger Maris Cancer Clinic means that every patient will be handled by a collaborative group of medical people dedicated to using the best practices for treating cancer. Nancy coordinates all the appointments and acts as the liaison between patients and doctors. Nicole continues, "Nancy was invaluable. How could I have known who to call or when to do it? The care coordination piece is excellent in terms of preparing and helping you know what to expect. She was wonderful."
Treatment Team
When Nicole met with her team of doctors, she was surprised to learn that they didn't mandate a treatment. Instead, they gave her a list of treatment options and allowed her to make informed choices for her case. Nicole, at first, expected them to give her the "answer." Later, she was comforted knowing the doctors were going to consult together and be on the same page in terms of her treatment. After hearing her options, Nicole chose to begin with eight rounds of chemotherapy followed by surgery and then radiation.
This collaborative approach that Nicole experienced is extremely effective. In fact, MeritCare recently received a three year, full accreditation by the
National Accreditation Program for Breast Centers (NAPBC). Administered by the American College of Surgeons, this program is incredibly competitive. MeritCare is one of 51 hospitals, a mere 5 percent in the nation, to achieve this status.
Moving Forward
She began chemotherapy, Nicole was thankful for her compassionate nurses. She explains, "During my first treatment, I was terrified. The nurse sat with me and rubbed my back and patted my leg and didn't start until I was ready. She explained everything to me and was wonderful — every time."
Post chemotherapy, Nicole opted to have a lumpectomy. Before her surgery, doctors tested one of her lymph nodes, which turned out to have cancer. Luckily, the other lymph nodes were cancer free. Nicole says, "The cancer was just beginning to spread. When we found the lump, it was the right place, right time, which is funny to say about cancer."
Following surgery, she began 30 radiation treatments, five days a week for six weeks.
More Safeguards
When her treatments concluded, Nicole went back to complete the genetic testing she had originally met Dr. Grimm about. It turned out she had the genetic marker for cancer. Such an outcome is rare.
Dr. Grimm says, "Most breast cancer is not related to family genes. Ninety percent of breast cancer is not thought to be inherited." Because of her positive test, Dr. Grimm was concerned about ovarian cancer. Nicole's mother not only had breast cancer but also uterine cancer. In a difficult decision, Nicole chose to have her uterus and ovaries removed, as a preventative measure.
Nicole, as a healthy survivor, surrounds herself with family, especially her two daughters. Still she thinks about cancer nearly every day. She says, "I am grateful that I have my life. I do believe that prayers were answered. For me, that made a difference emotionally and mentally. I am alive — that is a good outcome! It could have been a lot worse, and I know that."