Learning about Breast Cancer
- Philecia La’Bounty was 29 when she first felt a lump in her breast. But given her age and the fact that she had no family history of breast cancer, her mammogram request was denied. She’s now fighting metastatic breast cancer and freezing her eggs in the hopes of becoming a mother some day.
- Metastatic breast cancer – also called “stage four” breast cancer – means that the cancer has spread, or metastasized, beyond the breasts to other parts of the body. There is technically no cure, but advancements in treatments can dramatically improve outcomes and that is something to be hopeful for.
- According to our experts, people with breast cancer face unique challenges when it comes to fertility. If they need chemotherapy, 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. Fertility preservation practices for women can include egg and embryo freezing, ovarian tissue freezing, ovarian suppression and ovarian transposition.
Philecia La’Bounty of Huntington Beach, California, was 29 when she first felt a forward-facing, marble-sized lump in her left breast.Read More
La’Bounty didn’t have health insurance at that time, but an alternative health care program allowed her to get a physical exam and an ultrasound.
“Within two weeks, we got the results,” La’Bounty explained. “They said it was a ‘benign, gunky cyst — nothing to worry about.’
Even her blood work came back normal, but La’Bounty knew something seemed off so she she requested a mammogram. Sadly, se was denied because she was young and had no family history of breast cancer.
“I never had a cyst in my entire life,” she said. “Why is it happening now, and why am I being brushed aside? They convinced me that I was OK, [and] I had no other signs.”
This delay only allowed her tumor to grow – 8 cm in “four-to-eight months” to be exact. And when she went back to the clinic, medical professionals referred her for an emergency mammogram and an ultrasound. That’s when the now 35 year old got her results.
“I said, ‘This is bad,’” she recalled. “They tried their hardest, but you can just tell in their faces.
“I was like, ‘Oh my God. I did what I was [supposed] to do. I saw something, said something and you guys told me I was too young [for a mammogram].”
La’Bounty underwent eight biopsies, another mammogram, an MRI and several more scans. And at one point, she started to feel like she couldn’t breathe.
“I told my boyfriend, ‘I can’t breathe. I don’t know if it’s [because of] what’s going on, but I need to be seen,'” she said. “We went into the ER. Finally, the doctor comes in and says, ‘You can’t breathe because of all the tumors in both of your lungs.”
Later that day, doctors called her to explain that she had stage four breast cancer with metastasis (spreading) to both lungs, her sternum and lymph nodes in her left armpit.
For treatment, she’s had six rounds of different types of chemotherapy that left her tumor free for now. But now she’s dealing with fertility issues since her hormone-driven cancer diagnosis makes it unsafe to carry a child, her ovaries and fallopian tubes were removed, treatments put her in early menopause and her chemotherapy made her “sterile.” She does still have a uterus and cervix, however, and she decided to freeze her eggs in the hops of having children later down the line.
“I’m young, and I don’t plan to die,” she said explaining her fertility plans. “Now we are in talks [about] finding a surrogate.
“Yes, I’ll be a mom someday, but I’ll never get to [fully] experience that because cancer took that away from me.”
La’Bounty knows she’ll be “fighting forever,” but that doesn’t mean she’s going to stop living.
“On paperwork I’m classified as terminal, but I’m not going to let this take me anytime soon,” she said. “We are just trying to figure out a new normal and how to make our dreams work with everything I have going on.”
In sharing her story, La’Bounty hopes that other people can understand that breast cancer doesn’t discriminate by age.
“I had not seen someone remotely close to my age going through this, until I was in this community,” she said. “99 percent of the women that I met were diagnosed or misdiagnosed like me in their 20s and early 30s. I met one woman who was 18 years old when she was diagnosed with breast cancer.”
She also has some advice for other young people to consider if they are questioning their health or diagnosis: fight harder and demand testing if you feel you need it, listen to your bodies at all times, “fire” your doctors if they’re not listening to you or you don’t like the treatment path they’ve laid out for you and don’t give up until you’re 100% positive you are okay.
“I’m also shouting from the rooftops to raise awareness to make cancer a chronic illness rather than a death sentence because women deserve more,” she said.
Understanding Metastatic Breast Cancer
Metastatic breast cancer – also called “stage four” breast cancer – means that the cancer has spread, or metastasized, beyond the breasts to other parts of the body. It most commonly spreads to the bones, liver and lungs, but it may also spread to the brain or other organs.
And while there is technically no cure for metastatic breast cancer, there are a wide variety of treatment options used to battle the disease including hormone therapy, chemotherapy, targeted drugs, immunotherapy and a combination of various treatments.
In a previous interview with SurvivorNet, Dr. Elizabeth Comen, an oncologist with Memorial Sloan Kettering Cancer Center, explained how she tries to management breast cancer when it has progressed to a later stage.
“With advanced disease, the goal of treatment is to keep you as stable as possible, slow the tumor growth and improve your quality of life,” she said.
The American Cancer Society reports that there were more than 3.8 million U.S. women with a history of breast cancer alive at the start of 2019. Some of the women were cancer-free, and others still had evidence of the disease, but they also reported that more than 150,000 breast cancer survivors were living with metastatic disease, three-fourths of whom were originally diagnosed with stage I-III. And with ongoing advancements in treatments and options out there today that can dramatically reduce symptoms, there are many reasons to be hopeful.
One major advancement that’s made recent headlines is the reclassification of some advanced breast cancers as HER2 “low.” During an interview on ABC’s Good Morning America, Dr. Comen highlighted an exciting treatment for this new classification of metastatic breast cancer patients.
“One of the most challenging types of cancer to treat is metastatic breast cancer,” Dr. Comen said. “And a new treatment, an FDA approved treatment, called Enhertu or T-DXd is being used to improve the survival of patients with a new classification of metastatic breast cancer called HER2-low metastatic breast cancer,” said Dr. Comen. “So, for anybody watching if they or their loved one has metastatic breast cancer, it’s critical that they ask their doctor, ‘Do I have HER2-low breast cancer and might this be an appropriate treatment for me?”
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. Options for women include:
- Egg and embryo freezing (the most common practice)
- Ovarian tissue freezing
- Ovarian suppression to prevent the eggs from maturing so that they cannot be damaged during treatment.
- Ovarian transposition, for women getting radiation to the pelvis, to move the ovaries out of the line of treatment.
No matter what course of action you choose to take, it is important that all women feel comfortable discussing their options prior to cancer treatment.
In a previous conversation with SurvivorNet, Dr. Jaime Knopman, a reproductive endocrinologist at CCRM NY, says 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 outlined them for us in a previous interview:
- Young women who need chemotherapy 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.
Living with Cancer
Life doesn’t slow down for a cancer diagnosis, but that doesn’t have to be a bad thing. And it’s important to remember that a cancer diagnosis – even stage four – does not mean the end of your life. In fact, our experts say that prioritizing your overall wellbeing and continuing to do the things that you love can be very beneficial.
Dr. Geoffrey Oxnard, a thoracic oncologist at Dana-Farber Cancer Institute, shared three things he tells his lung cancer patients about living with the disease:
- Don’t act sick – “You can’t mope around,” he said. “Do things, and in doing things, you will stay active.”
- Don’t lose weight – “Eat what you need to do to not lose weight,” he said. “I like my patients pleasantly plump.”
- Don’t be a tough guy – “When you’ve got lung cancer, you need work with your doctor to keep your medical conditions under control.”