Blogs > Navigating breast cancer: A project management approach

Navigating breast cancer: A project management approach

From adventure seeker to project manager: Carolyn Nickels faces triple-negative breast cancer with her family by her side.

Carolyn Nickels, her sister, and her nieces, stand with their arms around each other

At the time, I had been thinking of joining my niece Kristin and her children on a trip to the Pocono Mountains to ski and snowboard. The possibility of breast cancer was not on my radar when the doctor's office called to tell me they were scheduling me for additional imaging based on my mammogram results.

I went to the appointment the following day by myself. It was a bright, sunny day, warmer than usual for January. I was calm and confident. I had not felt a lump or even a bump in either of my breasts. All that changed after my ultrasound when the radiologist said that I had a suspicious area under my right nipple measuring 3.5 centimeters. A subsequent needle biopsy confirmed early-stage triple-negative breast cancer (TNBC), one of the most aggressive subtypes.


My project management approach

Though a triple-negative diagnosis was not what I had hoped for, I’m a firm believer that knowledge is power, and I researched everything I could. I have experience with project management and felt the most effective way to navigate this would be to create a personal project. Projects have a beginning, an end, and some deliverables sprinkled in for good measure. Plus, they have milestones, reasons to celebrate. This approach gave me a sense of control, which helped me feel calmer. I gathered the information I needed regarding treatments, side effects, and survivorship. Outlining my expectations, I began working on my project. I organized the information into clearly labeled sections within my binder for easy reference: Treatment Plan, Timeline, Side Effects, Survivorship, and My Team.

Now it was time to tell my family.


Sharing the diagnosis with family

I knew from the beginning that this would be emotionally difficult for them because my mother had passed away after a metastatic breast cancer recurrence, and my sister, Marilyn, had lost her best friend, Cindy, to TNBC. As I carefully planned how to break the news, I decided the best way to begin was to lay out the facts and also point out the differences between my diagnosis, both from our family history and from what we knew about Cindy's case. Both Mom and Cindy had unique experiences, and I wanted to emphasize the importance of understanding the specific details of my own situation, which included advancements due to a recent clinical trial, Keynote-522.

Since Marilyn had accompanied me to my needle biopsy, everyone in my family was anxiously awaiting the results. I decided the best way to tell everyone was in person and waited until they had finished dinner before going to their home, two blocks away.

My timing was good. They had just cleared the kitchen table from dinner. As soon as I arrived, I felt their uneasiness. There was a silent heaviness of the air, and their solemn expressions were waiting for the unwanted news. I laid my binder on the table and passed out a sheet of information I wanted to share and a pen.

First, I addressed the elephant in the room by saying there had been tremendous progress in treating breast cancer in the last few years, and I was lucky that I had options that our mother and our friend Cindy had unfortunately not had. Also, my cancer was caught at an early stage and had not spread into the lymph nodes, so my prognosis was favorable.

Then, I summarized things that could happen during the treatment. I mentioned that lack of appetite and weight loss were side effects but quipped that I wouldn't mind losing a few pounds. I discussed the option of cold capping during chemotherapy, a process to prevent hair loss. Lastly, I mentioned that if surgery were needed, I would opt for a double mastectomy because I wanted to minimize as much of the risk of re-occurrence as possible. Besides, I didn’t want these breasts— they tried to kill me. Smiling, I joked, “Having new breasts at my age would be a perk and something to look forward to.”

It was a lot to comprehend for everyone, and we discussed their concerns. Wanting to end on a good note, I reminded everyone how devastated we were at my mom's breast cancer diagnosis and how we came together to make the best of her new normal. We stayed positive and found ways to add fun to her medical treatments. Lunches at her favorite restaurants and ice cream always followed her radiation treatments, and shopping trips were a must after doctor appointments. We won America's Funniest Home Videos that year and were finalists in the championship round.


Carolyn Nickels in her chemo suite chair with a cold cap

For me, the worst was over. I had dreaded sharing my diagnosis because, to my family, I was the strong one. I never got sick, and the only time I wound up in the hospital was when I had a broken bone or pulled a muscle from an adventure gone wrong.

Carolyn Nickels


As I was heading to the door to leave, I turned and said, "We can't change this, but we’ll start positive. Let's follow Mom's example.” We did just that.


Family support and adventures

I have always been a bit of an adventure junkie and thought trying something new would be a fun distraction for all of us. I mentioned it to my niece Kristin, who gave me a gift certificate to try indoor skydiving at iFly in King of Prussia, PA. She and my nephews joined the fun. My whole family came to watch me fly around with Kristin and my nephews. We had so much fun! A few weeks later, Marilyn, her husband Dave, and their daughter Colleen threw a party for me before I began my chemotherapy sessions. These events were just the beginning and helped “cement” the way I wanted to handle my treatments.


Chemotherapy, surgery, and immunotherapy

After completing my chemotherapy treatments, I underwent a double mastectomy in August. I am delighted with the results of my reconstruction surgery performed in January. I am currently finishing my Keytruda (immunotherapy) treatments. I started Weight Watchers in December to take off the weight I gained from steroids during chemotherapy. I have just six more immunotherapy treatments to go.

As I look back, I can see that my project management skills helped me stay on track and focused. Plus, it helped me keep my family involved. Now, with treatment almost over, the reward is waiting for me: the beach this summer. Here’s to more adventures and sunny days ahead!

Carolyn Nickels with her nieces and nephews gathered on the sofa


The views and opinions of our bloggers represent the views and opinions of the bloggers alone and not those of Living Beyond Breast Cancer. Also understand that Living Beyond Breast Cancer does not medically review any information or content contained on, or distributed through, its blog and therefore does not endorse the accuracy or reliability of any such information or content. Through our blog, we merely seek to give individuals creative freedom to tell their stories. It is not a substitute for professional counseling or medical advice.


Stay connected

Sign up to receive emotional support, medical insight, personal stories, and more, delivered to your inbox weekly.