breast cancer in young women

Thyroid Cancer during Breast Cancer

“Ms. Huffman, have you noticed a fullness in your neck?”

This was the question I heard from my primary care physician, who I had gone to see for a mammogram referral, which would eventually lead to my breast cancer diagnosis.

“Yes, but I had a radioactive treatment several years ago to treat a goiter on my thyroid.  I had thought the treatment took care of that.”  Women on both sides of my family have had problems with their thyroid; my mom had her thyroid removed when she was 16, one of her cousins had thyroid cancer, and one of my aunts had thyroid cancer.

“Hmmm, I believe that may not be the case.  Regardless, you need to see a specialist and have this checked out further.”

For a period of almost two months prior to my breast diagnosis, I had numerous appointments for scans, biopsies and specialist consultations for both my thyroid and breasts.  My bosses, bless their hearts, let me have flexible hours at work to make up for the plethora of appointments.   If they hadn’t been so accommodating and helpful during that initial period, I surely would have lost my mind.

I was diagnosed with early stage breast cancer in late September 2010.   Several weeks afterwards, I met up with an endocrinologist to discuss the results of my thyroid biopsy.  He informed me that there was a significant chance I had thyroid cancer, too, and I needed to have my thyroid removed.

Being told that you may have cancer while you already have cancer, it’s surreal, to say the least.  My inner monologue was basically: “Hahahahahahahahahahahaha.”

Since the breast cancer was considered the biggest threat, treatment for those particular rogue cells took priority.  However, a month after I was done with chemotherapy, it was time for the thyroid to be exorcised . . . I mean, removed.

After the full thyroidectomy, I was a sight to be seen: bald, greyish pallor and sporting a giant neck wound.  The first night after my surgery, I fainted in the bathroom and woke up surrounded by unfamiliar nurses and doctors all saying my name really loudly.   Apparently, as I was falling down, I had hit my head and the nurse’s aide (who I had insisted that she stay outside the bathroom because “I’m an adult and don’t need help in the bathroom”) caught me as I crumpled to the floor.

It was a “fun” night after that, and I was sprung from the hospital on my 31st birthday.  Happy birthday to me!

It wasn’t easy trying to get my thyroid hormones leveled while dealing with radiation for breast cancer.  I felt tired in ways I didn’t think were possible.   Since I no longer had a thyroid, I take Synthryoid every day and will do so for the rest of my life.  I never wanted to be on a medication for the rest of my life before my thyroidectomy, but now that I am, I don’t care in the absolute slightest.  Given how much trouble my thyroid caused me in my 20s (i.e., untreated hyperthyroidism for years), my only regret is that I didn’t have it removed sooner.  When your thyroid is off, everything about you and how you feel is off.

Symptoms of hyperthyroidism (which I checked off most of them):

  • Difficulty concentrating
  • Fatigue
  • Frequent bowel movements
  • Goiter (visibly enlarged thyroid gland) or thyroid nodules
  • Hand tremor
  • Heat intolerance
  • Increased appetite
  • Increased sweating
  • Irregular menstrual periods in women
  • Nervousness
  • Restlessness
  • Sleep problems
  • Weight loss (or weight gain, in some cases)

Hypothyroidism (defined as a condition in which the thyroid gland does not make enough thyroid hormone) symptoms:

Early symptoms:

  • Hard stools or constipation
  • Increased sensitivity to cold temperature
  • Fatigue or feeling slowed down
  • Heavier and irregular menstrual periods
  • Joint or muscle pain
  • Paleness or dry skin
  • Sadness or depression
  • Thin, brittle hair or fingernails
  • Weakness
  • Weight gain

Late symptoms, if untreated:

  • Decreased taste and smell
  • Hoarseness
  • Puffy face, hands, and feet
  • Slow speech
  • Thickening of the skin
  • Thinning of eyebrows

I want to emphasize that if you think you could possibly be dealing with either hyperthyroidism or hypothyroidism, consult a doctor, who can order simple blood tests.   I felt off for so many years, and I had no idea it was because of an overactive thyroid.  I suffered from panic attacks, insomnia and a ravenous appetite that never let up.  Once a doctor figured out what was wrong and got my levels regulated, I felt normal again.

Dealing with thyroid cancer at the same time as breast cancer wasn’t easy or fun, but I’m beyond relieved that my thyroid is gone.  I admit that I miss my old chest often, but my thyroid?  Nope.  I hope it went straight to hell, which is where I’m sure it came from.

If you are a young, single woman just diagnosed with breast cancer.

This letter is targeted toward a young woman in her 20s or 30s – someone who isn’t married or has kids.  Someone like me.

To a young woman recently diagnosed with breast cancer,

I am so very sorry.  I wish I could tell you that everything is going to be okay, but I don’t know that.  Nobody knows, and I wish I could assail you with all the platitudes in the world, as if they could actually take shape and wrap you in a warm blanket, but that’s never helped anyone.  If you are looking for platitudes, then I am the wrong blogger for you.  (I truly believe that our language when it comes to cancer has become so superfluous and hyperbolic, veering drastically away from cancer’s reality.  I told the Boyfriend after hearing how I am such a “fighter” for the twelfth time that: “If one more person says I’m a fighter, I am going to straight up fight them.  Seriously, I will drop the damn gloves and take a swing.”)

Nothing breaks my heart than hearing how another young woman joined the cancer club, where we are the minority.  According to the American Cancer Society’s Breast Cancer Facts & Figures 2013-2014, the median age for breast cancer between 2006 and 2010 is 61.  We’re a part of a club that is comprised of women the ages of our mothers, aunts and grandmothers.    The Young Survival Coalition’s website states:

In 2009, the American Cancer Society predicted more than 190,000 new cases of breast cancer in women. They estimated that roughly 18,600 of these women would be younger than 45.

The amazing Gilda Radner said it best:

Having cancer gave me membership in an elite club I’d rather not belong to.

Cancer in young women is so rare, but after you’re diagnosed, it seems to be something you hear about a lot more often.  Having cancer when it seems like most of your friends are getting married or having children can be one heart ache after another.  You’re in the hospital getting tests or scans, and you’re surrounded by those 15 to 20 years older than you.

My advice to any young woman who has been diagnosed with some type of breast cancer:

1.) Do not google your disease because typically, if you go looking for trouble, you’ll end up finding it.  Googling is not your friend when you are diagnosed with cancer.    If you are going to google, please take the advice from Andrew Griffith’s advice:

Google wisely. Google (and Wikipedia) are a reflex. Don’t fight it. However, when looking at suggested links, go for more reliable sources. Any national cancer (e.g. American Cancer Society, Canadian Cancer Society) or health agency (e.g., National Cancer Institute), major cancer centre (e.g., MD Anderson and others), and any specific cancer organization (in my case, the Leukemia and Lymphoma Society, and LLS Canada).

The internet can be the Wild Wild West, and anybody with internet access can post their crack-pot theories about cancer.  (“You can cure cancer with eating nothing but carrots!” or “.)  If you’re going to look for information, go to reputable websites.   A great source for information can be other women currently going through treatment or who recently went through treatment.  One place to find a great source of information would be the BreastCancer.org’s message boards.   You can find someone your age, or someone with your type of breast cancer, or another patient who lives nearby.

This is another great resource for information – the #BCSM community is amazing.  You will never find another group of individuals more passionate and focused not only on research, or awareness for the rarely talked about breast cancers, but helping other women (and also men) going through treatment.   If you have a twitter account, browse through the #bcsm hash tag, and you will be guided however you need.  If someone doesn’t know the answer, they may know someone who may know the answer.  I’ve befriended many people from the #BCSM community and my life has been the better for it.

Definitely, always and forever, take the advice of your medical team.  If you have any questions of something you have learned or come across, the best person to ask is your doctor.

2.) If you think you may want to have a child later down the road, please tell your doctor and get a recommendation for a great fertility specialist.  When you are diagnosed with breast cancer, sometimes you live minute by minute.  Hour by hour.  But you should look ahead and talk with a fertility specialist about your options because cancer treatment may take those options from you.   I discussed cancer and fertility a couple of months earlier.

3.) Lastly, this is something I wish I had done when I was first diagnosed – get thee to a counselor.  Don’t pass go.  Don’t collect $200.  Find help.  Find someone, like a therapist, or a support group, and take care of your mental health.  I made the mistake of thinking, “Oh I can handle this,” but I got so overwhelmed after my fifth surgery (i.e., the tissue expander exchange surgery) that I just collapsed.  To say it was bad would be the understatement of the year.  I could barely function either at work or in my personal relationships.  With the love and encouragement of my friends (one of who researched nearby therapists and found the one I still go to a year later), I went to a therapist and was able to learn how to deal with my post-cancer anxiety and depression.

I should have seen a therapist sooner, like as soon as I was diagnosed.  I truly believe that if I had, I may not have sunken so low after my fifth surgery.

Going through active treatment, you feel strangely safe and secure, even though you are living day-to-day in a passive role.  Every day, you are doing something to fight cancer.   Chemo kills all the bad cells!  Radiation zaps the cells!  Surgery removes the cells!  It’s a lot to process, to say the least.   Mental health is often overlooked while you’re going through treatment since the primary focus is on your physical being.

Depression and anxiety is so common after a cancer diagnosis.  Without the safety and security that active treatment gives you, you feel lost.  Alone.  Consumed with the thoughts: “What if it comes back?”  The Dana-Farber Cancer Institute website has great advice on how to cope with this fear:

Be informed.
Learning about your cancer, understanding what you can do for your health now, and finding out about the services available to you can give you a greater sense of control. Some studies even suggest that people who are well informed about their illness and treatment are more likely to follow their treatment plans and recover from cancer more quickly than those who are not.

Express feelings of fear, anger, or sadness.
Being open and dealing with their emotions helps many people feel less worried. People have found that when they express strong feelings like anger or sadness, they are more able to let go of these feelings. Some sort out their feelings by talking to friends or family, other cancer survivors, or a counselor. Of course, if you prefer not to discuss your cancer with others, you should feel free not to. You can still sort out your feelings by thinking about them or writing them down on paper.

Please, please please take good care of your mental health while you go through treatment.  If it’s online or in person, make time.   Asking for or seeking help when you’re diagnosed with breast cancer isn’t a sign of weakness.  It shows a real sign of strength.  Take care and be kind to yourself.

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