What I Wish I Knew About Breast Cancer Treatment and Its Side Effects

I took the call at work. Stage 2 invasive ductal carcinoma—breast cancer. I had found the lump myself only two weeks prior, by accident, when attempting to warm myself after a cold outdoor run. I was 29 years old, newly engaged to be married, and in what I had previously believed to be my peak state of health and physical fitness.

Until I wasn’t. 

The tears flowed like rain. A flash flood of emotions. The flash flood became a storm of emotions that all a sudden was my new reality.

Prior to my 2016 diagnosis, I knew very little about breast cancer and its respective treatments. I also didn’t know the importance of monthly breast self-examinations or that breast cancer could develop in young people. I soon learned there was far more to the disease, its treatments, and what subsequent medical surveillance could look like. I got a crash course through living it myself.

Upon first meeting with my medical oncologist, I learned that tumors could carry different disease markers, or biomarkers—measurable indicators of disease. For breast cancer, the markers include estrogen receptors, progesterone receptors, and human epidermal growth factor receptor 2 (a growth-promoting protein found on the outside of all breast cells). 

The breast cancer I had was known as triple positive, or ER+, PR+, HER2+. This meant my cancer cells were growing in response to my body’s own expression of estrogen, progesterone, and HER2. This information would guide treatment. 

The treatment plan set out by my oncologist included five months of intensive intravenous (IV) chemotherapy, surgery, and radiation. 

I first learned the importance of communication with my medical team when I found myself becoming greatly dehydrated during chemotherapy, unable to maintain adequate hydration levels through drinking alone. In sharing this concern with my medical team, they arranged that I receive IV fluids three times in the week following each treatment. How fantastically helpful this was.

With my tumor fueled by estrogen and progesterone expression, my healthcare team put me in medically induced menopause at the start of my treatment to lower my hormone levels. To bring on menopause, I received monthly hormone injections as well as a daily aromatase inhibitor medication, which stopped my body’s production of the hormone estrogen. The treatment had the goal of maximizing treatment response while preventing future recurrence.

Walking this path with breast cancer has at times felt arduous beyond measure, especially when attempting to envision my future. I have been fortunate to receive excellent counsel and guidance from my medical team throughout the experience. But to deny the mental, emotional, and physical challenges that have ensued after cancer would be an abbreviated portrayal of my story. 

My oncologist believed that in the months after my hormone treatment ended, my body would return to a pre-menopausal state, which it did. But there are medical conditions that can occur secondary to a menopausal state, including osteopenia (low bone mass) and osteoporosis (a disease that weakens your bones). 

Never did I imagine that my bones would thin to the degree of osteopenia progressing to osteoporosis in my early 30s. But for at least two years after treatment, that’s what dual X-ray absorptiometry (DEXA) scans—which measure bone density (bone thickness and strength)—showed. This is actually expected during medically induced menopause because of the lower estrogen production.

Thankfully, my bone density has been well-managed and improving since. I was able to move from the osteoporosis range back to the osteopenia range through lifestyle modifications and supplementation with vitamin D3 and calcium.

Cancer was never on my radar as a young woman who believed she had her whole life ahead of her. And while our wedding was postponed a full year so that I had time to complete active treatment and begin my healing process, I never imagined my husband and I would be childless at 36 due to endocrine therapies and fertility struggles delaying this process. We do remain hopeful, though, and will consider the next steps if needed.

No one told me in the beginning that the terrible illness from chemotherapy, the discomfort of the radiation burns, and surgical complications with breast reconstruction due to radiation-related tissue damage would, for me, be minuscule compared to the body image issues associated with weight gain and a unilateral mastectomy. There’s also having to live with the constant awareness of recurrence risk.

Now in my seventh year of survivorship, I have discovered many helpful coping strategies. I have found that in honoring how my body has withstood these hardships while putting full trust in my medical team, I have begun to again feel safe in my body. The tears that fall now—they’re different. Instead of sadness, they represent gratitude, sentiments of survival, and overcoming.

There is a lot I did not know prior to my receiving that fateful call, but what I do know now is that we have the ability to self-advocate and work in tandem with our medical teams to identify the best interventions and methods of supportive care for achieving long-term survival while positively impacting my quality of life. And best of all, I now know that there is great life to be discovered after breast cancer. It is indeed possible, and it is every bit worth living.