The Realities of Breast Cancer at 19
- Anne With An E star Miranda McKeon just went through her first round of chemotherapy for her breast cancer treatment. Just days prior to that, she froze her eggs in case treatment affects her fertility.
- McKeon has been very brave and vulnerable in sharing the details of her cancer journey thus far. In her most recent Instagram update, she said the start of chemotherapy had her “overflowing with gratitude and simultaneously feeling gut wrenching loss” as she prepares for the challenging months ahead.
- According to our experts, people with breast cancer face unique challenges when it comes to fertility. If they need chemotherapy like McKeon for example, their eggs could be damaged. Also, if a women’s treatment calls for medication to stop specific hormones, they might not be able to get pregnant for several years or, in some instances, 10.
The actress and University of Southern California student was diagnosed with breast cancer on June 14 and has no family history of the disease. Since then, she has been very open about sharing her cancer journey with fans. And while she has moments of optimism, McKeon has also been honest about her struggles including struggling to sleep, losing her appetite, feeling emotionless and missing her friends.Read More
In her most recent update, McKeon shared that she had just begun her chemotherapy treatments and was “overflowing with gratitude and simultaneously feeling gut wrenching loss” as she begins this next chapter of her cancer journey. With her first round done, she has seven more to go in her AC-T regimen. She’ll have chemotherapy once every two weeks – four months in total – followed by surgery and radiation.
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“There were a few bumps in the road with treatment being pushed back a day but the deed has been done and I currently have my first cocktail of AC chemo circulating through my body,” she wrote on Instagram. “It has been an emotional 2 days. Yesterday’s delay dropped my stomach to the floor as I had been mentally preparing for ~the day~ for weeks only to find out that it was being moved back 24hrs. BUT, my friends surprised me at dinner, surrounded me with love when I felt so broken, and my mental state did a 180.”
Despite knowing she has a “hard few months” ahead of her, McKeon is taking the time to appreciate that she’s one step closer to the finish line.
“The relief I was longing for with starting treatment has me doing an internal (and external) happy dance,” she wrote. “Hoping my upcoming chemo side affects don’t rain on my parade.”
Just prior to beginning her chemotherapy, McKeon also shared that she had taken steps to give her the best chance of a future pregnancy in case treatment affects her fertility later down the line – an “insurance policy” if you will. In a new post on her blog entitled Freezing My Eggs At 19, McKeon explained the process she went through after her doctor discussed “family planning options.”
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“This past week I’ve spent most of my mornings at a fertility clinic and all of my nights (@8pm) doing self injections for an egg harvesting process,” she wrote on July 6. “It’s so that I have a safety net of options when I want to have little clones down the line, as chemotherapy increases the risk of infertility. I wasn’t ready to share this step on social media yet because for some reason I though that people would automatically assume that I can’t have children naturally in the future- which is not true. Essentially, I’m taking a conservative approach by freezing eggs so that I can ensure things run smoothly in however many years.”
And though she has come to the conclusion that there would never be a “right time” for all of these steps along her cancer journey, McKeon admitted that freezing her eggs at 19 felt about “10-15 years too soon.” Regardless, she’s taking everything in stride and determined to openly share the intimate moments of her journey along the way.
“So… we have eggs on ice,” she wrote. “May they never be needed, and donated to science down the road after I have my kids on my own and get to bring them into this weird, messy, beautiful world.”
Understanding Breast Cancer
The American Cancer Society estimates that about 281,550 new cases of invasive breast cancer and about 49,290 new cases of ductal carcinoma in situ (DCIS) will be diagnosed in women in the United States in 2021. Although most cases are found in women, men can develop this cancer too – though it is more rare, in part, due to the simple fact that men have less breast tissue.
There are many treatment options available for people with this disease, but treatment depends on the specifics of each case. Identifying these specifics means looking into whether the cancerous cells have certain receptors. These receptors – the estrogen receptor, the progesterone receptor and the HER2 receptor – can help identify the unique features of the cancer and help personalize treatment.
“These receptors, I like to imagine them like little hands on the outside of the cell, they can grab hold of what we call ligands, and these ligands are essentially the hormones that may be circulating in the bloodstream that can then be pulled into this cancer cell and used as a fertilizer, as growth support for the cells,” Dr. Elizabeth Comen, a medical oncologist at Memorial Sloan Kettering Cancer Center, tells SurvivorNet.
One example of a type of ligand that can stimulate a cancer cell is the hormone estrogen, that’s why an estrogen receptor positive breast cancer will grow when stimulated by estrogen. For these cases, your doctor may offer treatment that specifically targets the estrogen receptor. But for HER2 positive breast cancers, therapies that uniquely target the HER2 receptor may be the most beneficial.
The Importance of Mammograms
Screening for breast cancer is typically done via mammogram, which looks for lumps in the breast tissue and signs of cancer. And while mammograms aren’t perfect, they are still a great way to begin annual screening. The American Cancer Society (ACS) recommends women begin mammogram screening for breast cancer at age 45. In a previous interview with SurvivorNet, Dr. Connie Lehman, chief of the Breast Imaging Division at Massachusetts General Hospital, says people who haven’t reached menopause yet should prioritize getting a mammogram every year.
“We know that cancers grow more rapidly in our younger patients, and having that annual mammogram can be lifesaving,” says Dr. Lehman. “After menopause, it may be perfectly acceptable to reduce that frequency to every two years. But what I’m most concerned about is the women who haven’t been in for a mammogram for two, three or four years, those women that have never had a mammogram. We all agree regular screening mammography saves lives.”
And regardless of age or family history, it’s important to be vigilant and speak with your doctor if you ever feel a lump in your breast. Voicing your concerns as soon as you have them can lead to earlier cancer detection which, in turn, can lead to better outcomes.
Fertility and Cancer Treatment
Infertility can be a side effect of some cancer treatments, but there are options to consider. Fertility preservation, for example, is available to women of childbearing age. The most commonly used practices are egg and embryo freezing, but other options are also available.
No matter what course of action you choose to take, it is important that all women of childbearing age feel comfortable discussing their options prior to cancer treatment.
In a previous conversation with SurvivorNet, Dr. Jaime Knopman, a reproductive endocrinologist at CCRM NY, said that time is precious when dealing with fertility preservation for women with cancer. In other words, the sooner the better when it comes to having these important fertility conversations with your doctor.
“The sooner we start, the sooner that patient can then go on and do their treatment,” Dr. Knopman said. “A lot of the success comes down to how old you are at the time you froze and the quality of the lab in which your eggs or embryos are frozen in.”
When it comes to breast cancer patients specifically, there are some unique challenges for women with the disease. Dr. Elizabeth Comen outlines them in a previous interview with SurvivorNet:
- Young women who need chemotherapy, like Miranda McKeon, could have their fertility significantly affected because many chemotherapy drugs can damage a woman’s eggs.
- If women are on a medication to stop the hormones which feed their specific kind of breast cancer, they may not be able to get pregnant for several years – in some instances 10 years.
- Many stage four breast cancers need estrogen to grow. Pregnancy is a very, very high hormonal state, so it’s not recommended in these cases.