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Photo by Robert Hood / Fred Hutch News Service
July 26, 2018 | By Susan Glick, as told to Colin Petersdorf
Life has a funny way of taking twists and turns.
Six months before I graduated from the University of California, I flew down to Los Angeles to visit my mom and that’s when she said the words you never want to hear: “I have cancer.” The catch was, no one knew exactly what type of cancer she had — all we knew was that it was extremely aggressive.
She told me she had been having chronic pain in her back above her hips and was losing weight quickly. She told me she discovered her doctor had been giving her shots of Novocain in an ignorant attempt to ease the pain. But she knew there was something else to the pain, something wrong. So she found a new physician, who immediately noticed the swollen lymph nodes in her neck and told her to seek treatment.
Ultimately, she moved to the then-brand-new Norris Cancer Center at the University of Southern California, where she was given a working diagnosis of stage 4 ovarian cancer because of high levels of an cancer marker called CA-125, the history and progression of the disease, and the original site of the pain. As strongly as her physicians believed it to be ovarian, a single definitive type of cancer was never officially identified.
She received amazing comprehensive care in which we all had confidence, all while nearly becoming family with her team of physicians, residents and social workers. I learned the value of a comprehensive cancer care facility.
After graduation I moved in with my mom and was honored to be her primary caretaker. I drove her to appointments, helped her with daily routines, and watched her go through cycle after cycle of ugly, devastating chemotherapy, which took a terrible toll on her body, particularly her kidneys. Before starting care at USC, she used to argue with her doctors to enable her to receive her chemotherapy through a drip while in the hospital, instead of receiving a “push” through a shot in the doctor’s office and sent home. How persistent she was!
She went into remission, and I moved to New York to live with my dad. Unfortunately, her cancer returned after two short months, and I rushed back to LA to live with her again.
Her chemotherapy worked, up to a point; the cancer would respond quickly, but it would return just as quickly. Ultimately, the treatment was just too toxic for her body without the benefit of beating the cancer. She passed away nearly a year after I graduated college and began living with her.
Then life decided to take a few more twists.
Nine months after my mom’s passing, her only brother — my uncle — died of lymphoma, which was, curiously, the second diagnostic consideration for her cancer. And then, a few months after that, my grandma passed at the age of 86. After losing her only two children, she seemed to lose the will to live. My dad was then diagnosed with lung cancer and passed away a short six months after that.
Those were the hardest years of my life. I was in my 20s and had just graduated from college, only to go through so much death and emotional pain. It changed me. I started to reorient myself away from materialistic objectives, focusing on what’s important in life. Friends were more focused on trends, but I focused on the really important things. I had watched so many close family members cross the cusp of life in a short time.
I stepped away from my undergraduate degree in archeology and pursued a master’s in business administration from the University of Washington before diving into health care administration with jobs at Group Health and Harborview Medical Center in Seattle, and then at Rutgers Healthcare in New Jersey. It just felt important to have a career in health care because when it comes down to it, I am working to provide services to individuals who stand where I stood at age 25.
In 2005, about 20 years after my parents passed, my gynecologist urged me do BRCA screening, which was pretty convenient, since I was working at Rutgers, an academic medical center. [BRCA gene mutations are associated with an increased risk of breast and ovarian cancer.] The day before my results were due back, my sister called. She had breast cancer with one nodal involvement.
Another branch of the family tree grew ominous fruit as a second wave of cancer began to wash over my family.
The next day, I found out I was negative for a BRCA mutation. However, given my family history, my doctor informed me that there might be some other familial predisposition for breast cancer yet to be detected or caught in the BRCA testing panel. And I thought, “Oh, OK, what next?”
After seeing my mom’s journey in her disease and treatment, I did not want my children (then in their early teens) to witness the ugliness I had in my 20s. My experience really colored my perspective on life; my mom was only 52 when she died.
After much research, I had an oophorectomy, a procedure to remove my ovaries. Studies had shown that oophorectomies also reduce the risk for breast cancer. It was a pretty drastic decision, but my mom’s cancer was bad — really bad — and I was scared.
Some people don’t have severe menopausal symptoms after the procedure. I was not one of them. The symptoms really disrupted my life, so my surgeon provided me with a combined hormone patch [estrogen and progesterone] to smooth the postsurgical transition.
Given my family’s extensive relationship with cancer, I was placed under observation. Within two years after my surgery, a small lump was found in my breast. This was just four weeks after a clear mammogram. Luckily, we found the cancer early enough where I did not need to undergo chemotherapy — my treatment consisted of a lumpectomy, radiation and five years of Arimidex, an estrogen inhibitor.
Looking back, I can’t help but wonder: In an odd twist of fate, did I give myself cancer? I was aware of the results of the Women’s Health Initiative linking [combined] hormone therapy to breast cancer; should I have never had the surgery and then worn the patch? Or, did I feed an already developing cancer, accelerating its growth and detection, allowing for it to be treated at an earlier stage – a form of perverse luck? Would I have lived for more years with a slower-growing tumor? The answers I’ll never know. I certainly know what I want to believe.
My sister and I are now both fine and healthy. I moved from New Jersey back to Seattle in 2015 and am now working as a research-compliance specialist at Fred Hutch. Given my past work and personal history with cancer, I feel at home in such a dynamic, mission-driven organization.
All in all, that period just after college when so many family members passed was difficult, then we had this second wave with my sister and myself. We had five people in my immediate family: my brother, my sister, my mom, my dad, and myself. Four out of five us had cancer — pretty amazing for my brother, right?
Recently, someone was surprised when I mentioned I was a survivor. Thinking about all the twists and turns that life has thrown at my family, yeah, I would say I am a survivor, like the rest of my siblings.