From physician to breast cancer patient: Cheryl’s story

Just six weeks after giving birth to her third child, Cheryl, a family medicine physician living in Alabama, was diagnosed with triple-negative breast cancer. She had been married for almost five years, and she was grateful to have a loving family and a successful career. Life was busy, and life was good.

Cheryl had always known she wanted to be a doctor. Her passion for healthcare started at the age of four when she decided she wanted to deliver babies. But as Cheryl progressed in her medical training, she discovered she enjoyed the conversations with her patients and knowing about their lives, which led her to specialize in family medicine. As a practicing physician, Cheryl's schedule was demanding, and she often found herself neglecting her own needs to ensure that her patients received the care and attention they required. As she says, “I wanted to make sure that I took appropriate time and care with people that oftentimes felt unheard and felt like they finally had a physician that was really interested in them.” So, after receiving her initial diagnosis of early-stage breast cancer in 2018, Cheryl returned to work and continued providing care to her patients.

Then, as she was celebrating her five-year wedding anniversary, Cheryl received the news that turned her world upside down: the breast cancer had metastasized to her brain. Cheryl had developed stage IV, or metastatic, breast cancer.

Her specialist advised her to spend as much quality time as possible with her loved ones.
Now Cheryl wants to share her story with you. She acknowledges the hardships frankly, but she wants you to know that you CAN handle breast cancer because she DID. Learn about Cheryl’s journey and how she has coped as she narrates her story and then chats with Jean Sachs, LBBC’s CEO.

Listen to Cheryl's story below or read the transcript.

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Transcript

Cheryl (00:01):
My name is Cheryl. I'm 40 years old, and I live in Birmingham, Alabama. I have triple-negative breast cancer, which was diagnosed in 2018 at my six week postpartum visit after having my third child, and the following year in 2019, I developed brain cancer that was related to my breast cancer. So, I now have the distinguished designation of being a stage four cancer patient, and I'm also a physician.

Jean (00:35):
Welcome to CAN and DID conversations, candid conversations with young women diagnosed with breast cancer. I'm Jean Sachs, the CEO of Living Beyond Breast Cancer. I want to thank you for listening to these authentic and inspirational stories. In this episode, Cheryl tells her story about being diagnosed with metastatic breast cancer and how it impacted her professional life and her sense of self. She is a wife, a mother of three, and a family doctor. She spoke with us from her home in Alabama, surrounded by many birds in her backyard. Afterwards, I will take a few moments to chat with Cheryl. Now let's listen to her story.

Cheryl (01:32):
Before I developed my breast cancer, I was living my life as a new mom, as well as the new wife. Within about five years, I was married and had three children, and I was balancing that out with my work as a family medicine physician. Those times were definitely challenging, but also I was very grateful to be in a place where I was able to not only have children and my husband to be surrounded by and to be loved on by, but I was also balancing that out with working a very demanding job that took a lot of my time as well. Now, looking back, I'm not so sure I had good balance of those things, but those things are only revealed in time. So initially when I had plans of being a doctor at four years old, I thought I want to deliver babies Throughout my process of becoming a physician, I also learned that with my ADD and my ability to see things from different perspectives, I actually like more than just delivering children. I enjoy the conversations that were involved with healthcare. And so I chose the specialty of family medicine because it would allow me to deliver children I wanted to, but also see people and patients of varying ages.

(03:04):
We oftentimes in our specialty of family medicine say that we treat folks ‘from the womb to the tomb’. And so it's, it's a pretty special thing to be a family medicine doctor and to have people share parts of their lives that can be very intimate and special to them.

(03:27):
My practice was very busy. There were a lot of demands with my job that I wasn't really prepared for. That medical school doesn't really prepare you for. There's a business side of medicine that oftentimes young dreamers such as myself don't realize we're going to be in the midst of a corporate method of managing healthcare. What I learned is that although many times if, if I had regular patients that were coming back for follow up, they may have 15-minute time slots that were allotted, but most times those conversations needed to take more than 15 minutes. And so for me, I didn't have much balance and I neglected myself in many ways by not eating on time or taking care of personal needs just because I wanted to make sure that I took appropriate time and care with people that oftentimes felt unheard and felt like they finally had a physician that was really interested in them.

(04:30):
I had been having some left-sided breast pain, redness and swelling that had progressed probably since my newborn was about two weeks old. And thankfully, my husband reminded me before my six week postpartum visit that I needed to make sure that I mentioned to my OB specialist that I was having pain because it is common for pain to happen in the postpartum period. I figured I had what's called mastitis, which is a breast infection. The last thing on my mind was that I had breast cancer, but when I went to my six week postpartum visit, my OB saw my breast, and pretty soon after that said, I don't even think my ultrasound tech should do this. Let's send you downstairs to the main area of this facility and let's get you an ultrasound done. And then that ultrasound proceeded forward with tech saying, well, we need to do a mammogram, but maybe it's because I am such a dreamer and an optimist. I really, even at that time, even with my medical background, just thought it's not going to be breast cancer. So probably about two hours after the mammogram was done, I was receiving a call that I needed to come back to the facility and have a biopsy done. And still with my optimism, I was hopeful that it wouldn't be that diagnosis. But within about three days, my husband and I were at home and we received the phone call that I had invasive ductal carcinoma, the breast and our worlds were just shaken.

(06:03):
Many women, and particularly Black women, can probably relate to my next statement, which is, of course, I went back to work with my breast cancer diagnosis. Maybe because of having a superhero complex or maybe because of the tough rigors that we go through as physicians, I was just used to going through tough stuff and I figured, well, I'll just go to work and handle this. And there have been many super heroes before me that have worked through their illness. So I did return to work and I made a decision not to let my patients know, at least the majority of them, I tried to not let know that I had breast cancer because I was already returning after maternity leave. And they had questions about my newborn baby and their excitement about that. So 15 minute appointments that were already 30 minute plus appointments would've been much longer had I mentioned my diagnosis.

(06:55):
And on top of that, we physicians oftentimes neglect ourselves. And we know that our purpose is to help others. And so I definitely didn't want to pour all of that into appointments for folks that needed my care and needed my listening ear. But I will say that I did have some patients that I just couldn't help but tell. And they were very supportive and keeping my illness a secret. I wasn't able to keep my diagnosis a secret from my colleagues and the staff members. I definitely needed to adjust my schedule due to the fact that I did have to go through chemo treatments and radiation.

(07:36):
It was a right around the time I was celebrating my five year wedding anniversary with my husband. So I was off of medication and we were able to celebrate our five year wedding anniversary away from our kids, which was great. But probably soon after that, which was probably about two to four weeks after I'd stopped taking the chemo medication by mouth, I started having a sinus pressure or what I thought was a headache. And I went through the process of thinking I had a dental issue and having a root canal done thinking maybe something was wrong with my teeth. But I have a very close friend who is also an oncologist and she's someone I've relied on throughout my breast cancer journey. And so when I told her what symptoms I was having, she quickly said, you probably need to get a head MRI done, just to be sure there's nothing else going on. In my case, there was something going on in my head. I had a left brain mass and that was identified in 2019. So the year following my initial breast cancer diagnosis is when I became a stage IV breast cancer patient.

(08:45):
I was totally freaked out. Anyone hears that they have an illness that can't be cured. There's no way that I think anyone cannot start thinking so many thoughts that are aren't positive. You think about your mortality, you think about your children, you think about leaving your husband and your parents and your loved ones and you think about how your career must change. I tried to be as strong as possible through chemo and radiation and did fairly well as it related to working. But after receiving my stage four cancer diagnosis, my specialist just flat out sat me down and said, you know what? You need to spend as much quality time as you can with your loved ones while you can. And that just really struck a chord with not only me, but as you can imagine, my husband as we're sitting in her office hearing these words.

(09:40):
So, I'm just amazed to be here! In some ways, I think that being a physician shielded me from some of the concerns that patients may have, particularly minority patients may have as it relates to the care that they're receiving. Only about 2% of physicians in the United States are Black women. And so it's kind of unique that I am a Black woman who is a physician, and I'm connected to other unicorns that are Black physicians and Black women physicians. And so one of my friends is an oncologist and she was able to help me navigate the specialist that she thought would be good for me to see to hopefully optimize my time here on Earth. And so being a physician has been helpful in that way, in that I think I have more of a confidence as it relates to the care that I'm receiving just because I know and feel that I'm in good hands.

(10:40):
And, in some ways, even some of the tougher aspects of cancer, like being knowledgeable of the numbers and such, I'm kind of aware of, although I've made a point to not look up statistics in my case, even though I am a physician, I didn't want to know numbers. But in some ways I do kind of know what the numbers say. And in some ways, being a physician allowed me to be settled in the fact that yes, I could die earlier than I expected to from this disease. But at the same time, I think too, in some ways that can be scary. Sometimes ignorance can be bliss, and so with some knowledge maybe you know too much and that can make you even more nervous. So it, it's really kind of been a little bit of both where I think being a physician has been comforting in some ways, but can also freak you out a little bit when you know too much.

(11:35):
One of the things that I'm grateful for is that I did have some wonderful relationships with patients that were honest and open with me about some of the struggles they would have as it related to their healthcare, including financial worries or being the primary provider, a family, and not being able to make scheduled follow up visits. You know, some, some patients say, Hey, I can't come here in three months. I can't afford to come in three months. Or, hey, I can't afford to pay for that medication at this time. I've got other responsibilities that take precedence over this medication. No matter how important you may say that medication is being on the patient side, I definitely gained a new respect and understanding of that. But as mentioned, I think I am grateful for the fact that I did have some humility as it related to patient needs even prior to becoming a breast cancer patient. But for sure I did experience and have experienced the financial worries that come with having to take medications for a long-term basis and having to follow up for treatments for the rest of my life.

(12:46):
I definitely see that and I see how that can be difficult to balance while trying to raise children while trying to take care of a home and be kind and loving to others while also being kind and loving to yourself. I mean, that's just really tough to balance. And even with the difficulties that I've had, I still can't relate to others that maybe even in worse financial situations than I am. I had humility before this, but I definitely have more hands-on experience with some concerns that patients had revealed to me prior to my diagnosis.

(13:22):
One of the things that's pretty interesting about me being a physician and a patient is that when I see my oncologist, yes, I am Cheryl the patient, but I'm also Cheryl, who is a physician. And so I try to make a point when I see my oncologist of listening in ways that let her know that I respect her knowledge, and I acknowledge that I am a patient. But what I appreciate about my oncologist is that she also gives me the opportunity to share with her some of the things that I have become more aware of as a patient, but I can relay it to her in ways that she can understand as a physician. And I can emphasize the importance of certain aspects of patient life that can help a patient feel better and can help with healing.

(14:18):
As a family medicine physician that I recognize through my tough work schedule is that a lot of times some of the same things that physicians are frustrated by are the things that patients are frustrated by. Physicians wish they could have more time with their patients, but physicians wish that they could be reimbursed in a way that would make that worthwhile. And a lot of times it's not the physicians that are directly in charge of determining how much those physicians receive in terms of their pay as it relates to the care that they're giving. I think it would be so great for us to really have real talk conversations with each other, patients to physicians, and that just comes with more communication and also being an advocate for yourself, which means sticking up for yourself. And if you can't stick up for yourself. Find someone who loves you enough to speak up for you and be okay with that.

(15:10):
Get support when you need it. I'm preaching to the choir when I say this because it's hard for me to ask for help too. So, when you hear this from me, know that it's coming from someone who also struggles with asking for help. My acceptance of help definitely wasn't easy, and I think it was just something that had to happen because I was really at a place where I had no other option but to receive help from others. It was really a group of Black women that really were the first to support me in amazing ways, and I'm just really grateful for them. But through the technology of Facebook, I became more open with them, felt more supported, survived longer than what I probably expected to survive and gain strength through that. And so, I started becoming more vocal online. And through that I learned about resources such as Living Beyond Breast Cancer and other organizations such as Metavivor.

(16:04):
And those organizations have offered me opportunities to, to speak up, but even more importantly for me, be supported by other people, not just women, but also men who are experiencing similar situations such as me in spite of not being the family medicine physician that I expect it to be. And so now I'm in a place where after being on this journey of having breast cancer for about five years, probably within the past year, I've started speaking up and out more online and I attended a retreat that allowed me to meet other women who have stage four breast cancer as well. And their support has really given me more of a confidence to move forward with the belief and knowledge that I still am able to be utilized in some way that's helpful to others. And so now I'm moving forward with speaking up about issues that are related to having breast cancer and as it relates to that relationship that I have between being a physician and a patient and hopefully being able to communicate in ways that both physicians and patients can recognize that we have ways that we can better serve each other to make things better.

(17:35):
I still haven't fully recovered emotionally from the fact that I don't have the same patient relationships that I had developed before as a physician. I've diagnosed many conditions and I've seen people that have had anxiety and had what we call panic attacks where they just get so nervous that they can't control sweats or shortness of breath and uneasiness. And I had never experienced that before until finding out that I would no longer be practicing and seeing the patients that I had taken care of for so many years. I'm also appreciative of the fact that I've had to slow down, and I've had to take time to recognize that beyond healthcare I am a complete person and that I have other ways that I can be helpful to this world and to my family and to those that I encounter.

(18:43):
Before I had breast cancer, I never really took time to consider who I was without medicine in my life. I, I knew since four years old that I wanted to be a doctor. And so I was on a path to become a physician since that time. And I now have opportunities to, you know, figure out if I want to start writing again or dance around the house or maybe go on a field trip with one of my kids if I have the opportunity to. And it's really something that it's, it's like a double-edged sword. I'm hurting in so many ways because my career is not what I expected it to be. But I'm grateful as well just for the opportunity to realize the other aspects of life that are just so beautiful and worthwhile. It's definitely something that I still struggle with and it's something that it's like waves.

(19:42):
It not only resounds to something that affects me, but it affects my family. I mean, I function as someone who was able to provide in a major way for my family financially with the assistance of my husband. And together we were able to make this house run.

I had this poem that I wrote a long, long time ago called Patience. And I actually said it one time when I was interviewing for my residency position, and it's patience with a C, but because I was going on my interview, she was like, “Oh, I thought you were going to be talking about like real life patients that you see in the office and stuff.” Anyway—
Patience, the virtue, I'm still seeking
Patience, the state that eludes me, won't include me in its presence
Patience when present is the present most prayed for
I'm in dismay for and I'm trying to wait for, don't know how long I stay for
This patience cuz I'm getting tired of waiting.
It keeps on passing me by
And I wanna cry cuz I still haven't what I'm looking for
I guess I'm searching for that peace of mind patience can bring
You know what those old folks have when they can chill on a bank all day waiting for fish?
Well, yeah, I'm fishing, too, for that patience fruit and from its roots, I'll obtain patience juice, which is obviously sweet because patience is so
Guess I'll wait a little while mo’, I just gotta be patient for patience.

Jean (21:14):
Cheryl's story had so many important and inspirational messages, Cheryl, I'm so happy I'm going to have a few minutes to talk with you. How are you?

Cheryl (21:24):
I'm doing great, thank you.

Jean (21:26):
Great to have you. You know, so many things hit me as I listened to, to your story and of course one which I think is probably the biggest take home for me is, you know, your life was really on fast forward, and you had your future planned. You, you spent a lot of time getting your medical degree, obviously building a relationship with your husband, having three children, starting a medical practice that has a lot of stress and then you're diagnosed with breast cancer and it was like hitting a brick wall. So I want to know, what was that like for you and what advice would you give for another young woman who's facing a similar situation?

Cheryl (22:06):
Well, I'll, I'll be honest, it's, it's one of those things that people say almost in a cliche way that it's something you just can't imagine happening. And it's so true in many ways, particularly being someone who's on a professional path. You have ideas of how things will go and you set plans for yourself and you have check marks as to what you'll do in life. And so I met a lot of those goals and had found some peace in that. And then to add onto that, having great times that were occurring with my relationship with my husband and the kids that followed, it really was just something so jarring and difficult to describe, but something that you also in some ways are prepared for <laugh> for the same reasons that you're steadfast on setting goals. You're also used to kind of tough times as well. And so in some ways I had to lean on past experiences of being through tough things, whether it was tough courses in school or just tough experiences in life to help me through this new adventure of having breast cancer.

Jean (23:09):
I wanted to just talk a little bit, I know that you were diagnosed with triple negative breast cancer, which we know is harder to treat more common in Black women and also often tied to having a genetic mutation. So did you get genetic testing and was that part of what you had to figure out?

Cheryl (23:29):
Yes, I did receive genetic testing and interestingly enough, in my case I kind of expected that there may be some genetic factor that caused my triple-negative breast cancer, but there were no genetic markers that popped up on my testing.

Jean (23:44):
Okay, well that's good news, right? Not, not something you have to worry about with your, with your children and your extended family, but still unusual to be diagnosed so young.

Cheryl (23:54):
Yes, definitely.

Jean (23:55):
You also talk a lot about, you know, being a, a Black doctor and that clearly there just aren't enough as we know 2% is not nearly enough and what you were able to do as a physician in treating your patients. So I'm just wondering, when you became a patient, were you a able to see any Black oncologists or surgeons or anyone along the journey?

Cheryl (24:19):
In my case, I was able to have a close relationship with a classmate from medical school who I've, who I've remained friends with named Dr. Erica Stringer-Reasor. But in our case we have a relationship that such and we have an understanding as physicians that she couldn't be my physician given that she is a close friend. So she did direct me to specialist that she thought would be helpful in my case. And those specialists are not Black or even minorities as far as I know. But I did have an assistant with my breast surgery that was a Black male and I thought that was pretty awesome to have a Black male surgeon involved with my case.

Jean (25:00):
So Cheryl, I just wanted to, to close by saying how moved I was by the poem that you wrote called Patience and how that was written long before your breast cancer diagnosis. So I can tell that you're both a creative person and a scientific person and probably many other things. So I really appreciate you sharing that.

Cheryl (25:20):
Well, thank you so much. And let me say as well, it just started raining here, so I apologize for that. But thank you so much.

Jean (25:29):
Of course. Just another thing you can't control, right?

Cheryl (25:31):
Right. Well, you know, one of the things that I do say now is that I definitely appreciate the seasons and the changes in weather a lot more since my breast cancer diagnosis. So even with the rain, I'm still smiling.

Jean (25:43):
Oh, well that's great. Well, thank you so much for sharing your story and for being part of Living Beyond Breast Cancer.

Cheryl (25:50)
Thank you as well.

Jean (25:53):
CAN and DID Conversations is a production of Living Beyond Breast Cancer. This episode was edited by Adriana Lecuona and produced by Jonathan Pfeffer. Listen to our other episodes on Apple Podcasts and Spotify or on our website, LBBC.org. If you need support and want to talk, LBBC's helpline volunteers are ready to listen. Visit LBBC.org to get connected. Many thanks to our sponsor, the Centers for Disease Control and Prevention.