Friday, July 1, 2011


Cancer Picked the Wrong Girl

Written by  Kim Mallett
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Cancer Picked the Wrong Girl
Introductions
My name is Kimberly Mallett and I am new to the world of blogging. Since you don't know me, let me tell you a little about myself. I recently turned 36, I am married to a wonderful man named Ryan, and I have two dogs and a crazy cat.  I am a daughter, a sister, a niece, a cousin, a granddaughter, a wife, and a friend.  I am a clinical psychologist and a researcher—hardworking and very ambitious.  I am loyal, caring, strong, full of laughter, and sometimes anxious. I am also a cancer survivor.

I never imagined I would describe myself as a cancer survivor, especially in my 30s.  I didn't smoke and used sunscreen.  I came from a relatively healthy family; in fact, all of my grandparents are alive and well. Little did I know I had a genetic predisposition that made me a ticking time bomb for breast cancer and dramatically increased my odds of getting ovarian cancer.  I wonder from time to time if it would have been better to know my risk since I am such a planner.  However, most of the time, we don't get the luxury of planning for cancer.  It is one of those bad surprises in life that you wish you didn't have to endure like an IRS audit or the flu—nothing you would ever choose. 
When it comes down to it, no matter how much you plan or prepare yourself, nothing can ever really brace you for the phrase: "you have cancer." It is a moment that is burned into my memory and I often replay it in my mind. Even though cancer was unexpected, I had a feeling the news from my doctor would not be good. The night before I received the biopsy results, I wondered, "is tonight the last night of life as I know it? Tomorrow will my life change forever?" Deep down I knew something was wrong, even though I was hoping for the best.

Meeting Cancer
"It's a cancer. . ." I heard these words and then my mind shut down.  At first I thought I heard the doctor incorrectly.  Then he asked me where I wanted to see a surgeon and I realized how drastically my life was about to change.  The night before, I was preparing for an all day work retreat, thinking of having a baby and looking forward to dinner plans with friends that weekend.  12 hours later I was making decisions about treatment while my legs were collapsing beneath me and wondering if I was going to die.  Talk about a 180-degree turn. 
While hearing I had cancer was shocking and unpleasant, breaking the news to my loved ones was worse.  Seeing the fear in their eyes, hearing the shaken voices over the phone was challenging to say the least.  To make matters worse, none of my family except for my husband knew I had a lump in my breast.  Why would they?  They all lived across the country and I didn't want to worry anyone for no reason.  The doctors were just being cautious after all.  
My husband and I called many of our family and friends that day.  We didn't want to draw it out and decided it was best to get it over with.  By the end we were emotionally exhausted after enduring one of the worst days of our lives.  I honestly didn't think I had any more tears left to cry.  Everyone wanted to know details, but the only information I could offer was what I had been told over the phone that morning.  I had a tumor in my right breast that was large enough to warrant chemotherapy.  The pathology report showed it was an aggressive cancer and I was scheduled to meet with a breast surgeon on Monday. I had no idea what the prognosis would be, just that I was slated for several diagnostic tests and at least a year of treatment.
A Voice of Reason
My aunt Paula is a radiologist who specializes in breast care and often diagnosis cancer.  My dad called her immediately after I told him the news.  I was lucky enough to talk to her the day I was diagnosed. She spoke to me in a way that normalized the situation and made it seem somehow manageable.  One of the first things Paula said to me was I was going to be ok. For instance, the fact that my cancer was aggressive would be expected because I was 31 and that was typical of cancers in women my age.  She pointed out that cancer was not a medical emergency (like a heart attack) and I would have time to work through my treatment options and develop a course of action versus having to react immediately.  She reminded me she sees women every day who have survived this disease andI would too.  In that conversation, Paula brought me back to my senses by reminding me I had some power over the situation.  When I was told I had cancer I felt helpless, as if I was at its mercy.  I had to remind myself that I was not a victim.  I realized I had a tough road ahead, but one thing was clear: cancer picked the wrong girl. In that moment, I waged war on the disease. I would do everything in my power to beat this unwelcome visitor in my body.  I also decided that I was not going to give cancer the power and privilege of calling the shots in my life.  The best thing I could do was act as normal as possible.  So after a day of uncertainty and tears, I cleaned myself up.  Ryan and I went out to dinner with friends; we even laughed.  It was Friday night after all.

A Tough Road Ahead
It felt like I was standing at the bottom of Mount Everest with an unbelievable challenge ahead. It seemed like such a difficult climb and I couldn't see the top.  However, I was a strong woman and I had friends and loved ones who would help me get through the most difficult times. Despite so many unknowns, the one thing I knew for certain was that failure was not an option.kim mallett breast cancer survivor
Less than 2 weeks after my diagnosis at my 32nd birthday party.  Friends gathered to show support as I started my journey.
Kimberly Mallett Bio
I have a Ph.D in Clinical Psychology and am currently a Research Faculty member at Penn State. My research is health based and focuses on the prevention of skin cancer and substance abuse.  I am originally from the west coast and moved to Pennsylvania in 2005.  I grew up in California and have lived in Boise, Idaho and Seattle, Washington.  I was diagnosed with breast cancer in 2007 at the age of 31.  I learned I had the BRCA 2 genetic mutation, which is why I was so young at the time of my diagnosis.  I underwent several surgeries (including a double mastectomy and hysterectomy) and months of chemotherapy. I am currently cancer free, happy, healthy, and enjoying life to the fullest!kim mallett breast cancer survivor and her husband in budapest
Celebrating my 36th birthday with my husband Ryan in Budapest, Hungary March, 2011
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Worrying has gotten the best of me

By livingbeyondbc
This entry was written by Jackie Roth, PhD student at Thomas Jefferson University. Jackie was diagnosed with Stage III A breast cancer at the age of 28. Every other Friday, throughout the entire year of 2011, Jackie will share a blog entry about her breast cancer experience. This year-long blog series is in honor of LBBC’s 20th anniversary.
To read Jackie’s previous entries, enter “ Jackie Roth” in the search box on this site.
Thinking about it now, I can’t even count the number of hours I’ve spent in a doctor’s office over the last year.  There were weeks when I had at least one appointment per day, if not more. And not to mention the countless hours in the waiting rooms too.  But, as I have just finished my radiation treatments, I am spending less and less time in the doctor’s office.
At first I didn’t notice the lack of doctor’s appointments affecting me because I have been completely consumed with writing my thesis.  I’ve been writing non-stop ever since my radiation treatments finished, trying to get my last seven years of research into one document.   I am definitely happy that my thesis is finished, all 250 pages, and now I have more time to focus on my life outside of school.

Jackie is happy to announce that she has completed her thesis! Congratulations, Jackie!

Recently, many of my doctors have said to me “See you in three, or even six, months.”  I even heard from one doctor, “See you in a year.”  I was completely shocked.  It just didn’t feel right knowing that I would not go back for months.  What if something goes wrong in that time? I know that I can always call in, but it is not the same reassurance as having a set appointment each week.
Adjusting to this “new normal,” or really my “normal before I was diagnosed,” has been the hardest part for me.  I was much more comfortable going to the doctor each week, having a plan in place.  I don’t really like the new plan of “we will image you twice a year and just see what happens.”  I can’t handle the idea of just sitting and waiting.  It is hard enough to wait now, let alone waiting for the results after I actually get a scan.  I am already worried about every little pain that I feel.  I can’t help but think it is the cancer coming back in a different place.  I know I am driving my husband crazy with all of the worrying.  One day I feel pain in my throat, the next day it is my hands, followed by my bones. My doctors have appeased me by sending me to specialists and running tests to calm my fears.  But I still worry.  Does the worrying every stop?  Does it stop when you make it to the 5-year-mark?
The transition of less doctor’s appointments is also difficult for me because I am physically moving jobs.  I will be graduating from school in three weeks and moving onto a new job located across town.  Currently, I spend my days across the street from my doctor and if I ever need them, I know they are right outside, just a minute or two away. 
In the back of my mind I know that most of this is out of my control.  I can’t control the fact that I have to move across town.  I can’t control the fact that now when I fill out forms at a new doctor’s office, I have to mark the “cancer” box when there is a check list of your past illnesses.  I can’t control if the cancer will come back.  Hopefully soon I will be able to control how much I worry because it is going to be a long and tiring five years if I continue worrying at this pace.
Can you give Jackie any suggestions on how she can curb her fear of recurrence? How did you put “worrying” aside and rely on your faith to get you through your recovery? Comment here or on ourFacebook page.
If you, like Jackie, have recently completed breast cancer treatment and find yourself worried about the “cancer coming back,” you may want to order LBBC’s Guide to Understanding Fear of Recurrence.
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This entry was posted on July 1, 2011 at 1:37 pm and is filed under fear of recurrence,Living Beyond Breast Cancer, quality of life, young women. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, ortrackback from your own site.
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UPDATE 3-Medicare will keep covering Roche's Avastin

Thu Jun 30, 2011 7:25pm EDT
* CMS says FDA decision does not affect its coverage
* Patients on Avastin were concerned about access to drug
* Insurance companies often take cue from CMS (Adds Genentech's plan for patient access program, background on sales and plans for more tests)
By Anna Yukhananov and Alina Selyukh
WASHINGTON, June 30 (Reuters) - Medicare will continue paying for Roche Holding's (ROG.VX) drug Avastin for breast cancer, regardless of what health regulators decide about the medicine's future, a spokesman said on Thursday.
The statement from the U.S. healthcare program could mitigate concerns that patients using the drug would lose insurance coverage should the U.S. Food and Drug Administration revoke approval for its use in breast cancer.
An FDA panel recommended on Wednesday that Avastin no longer be used to treat the disease because it has not proven safe or clinically beneficial in large trials. [ID:nLDE75T07M] FDA Commissioner Margaret Hamburg is expected to make a final decision later this year.
Doctors can still prescribe Avastin if the FDA revokes approval, but the move would influence recommendations by physician and insurance groups over whether to pay for it.
"The FDA decision, when it comes, does not affect CMS," Don McLeod, a spokesman for the Centers for Medicare and Medicaid (CMS), said on Thursday.
"The drug will still be on the market, doctors will still be prescribing it, and we will continue to pay for it," he said, adding that CMS often pays for off-label uses of drugs.
The Medicare statement could also influence private insurers. A WellPoint Inc (WLP.N) spokeswoman said on Thursday it would not drop support for patients already taking Avastin and is unlikely to disrupt coverage for new patients.
Patient groups say Avastin has saved lives even if the effect does not show up in broader sets of data. They pleaded with the FDA to keep its breast cancer label. Some 17,000 U.S. patients take Avastin, which costs about $8,000 a month.
"CMS essentially stands between (patients) and death, that's how we perceive it," said Terry Kelley, who formed the group Freedom of Access to Medicines and organized the protest outside the FDA building on the first day of hearings.
If the FDA pulls approval for Avastin in breast cancer, it could prompt a review of industry guidelines from groups like the National Comprehensive Cancer Network, which represents leading cancer treatment centers.
NCCN has so far not strayed from its earlier guideline, approving use of Avastin with the chemotherapy drug paclitaxel for some patients. CMS often takes its cue from such groups. Insurance companies, in turn, generally take into account CMS decisions to help determine coverage.
Roche's U.S. unit Genentech, for its part, plans to continue providing Avastin for free to women without insurance or whose insurance drops Avastin coverage, a unit spokesman said. The free medicine comes through Genentech's patient access program for women who make less than $100,000 a year, he said.
Using Avastin for metastatic breast cancer costs about $88,000 a year, based on people taking it for approximately 11.3 months, Roche said.
Genentech has limited the annual cost of Avastin to $58,000 for patients taking it for any FDA-approved indication. But if breast cancer loses that indication in FDA's final ruling, the cost limit offer would also have to end, Genentech said.
Genentech said global Avastin sales for Roche in 2010 were $6.2 billion, while U.S. sales of Avastin in 2010 were approximately $3.1 billion. It said 2010 U.S. sales of Avastin for breast cancer were about $750 million.
The Swiss drugmaker is now poised to carry out another trial of Avastin in a bid to prove it does significantly extend the time women live without their disease getting worse. [ID:nLDE75T0CS] (Editing by Derek Caney, Robert MacMillan, Gary Hill)
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