Five months after I gave birth to my second child, I was diagnosed with breast cancer. I found a lump while breastfeeding and mentioned it to my doctor, who ordered an ultrasound, just to be safe. The ultrasound turned into a mammogram, the mammogram turned into a biopsy, and two days later, a nurse called to give me the diagnosis over the phone.
I was 37, with an infant and a 4-year-old, and nothing this terrible had ever happened to me. The nurse asked me gently if I had a pen. As the world splintered soundlessly into a before and an after, I soothed my brand-new baby with my left hand and took notes on my brand-new cancer with my right.
Here’s the good news upfront: I’m fine now. I went through five months of chemotherapy, a lumpectomy with reconstruction, 19 rounds of radiation and a year of targeted immunotherapy. None of it was much fun — and all of it was made harder by having two small children to look after — but the treatment, as brutal as it was, did its job.
Pregnancy-associated breast cancer (P.A.B.C.), which affects approximately 1 in 1,000 women, is defined as any breast cancer that’s diagnosed during pregnancy or in the first postpartum year. For me, going from joyous new parent to cancer patient was jarring: new life skating right up against potential death. While being pregnant at 37 had classed me as “geriatric,” breast cancer at the same age turned me into an ingénue; all I kept hearing was how young I was.
And my hair! My poor hair was the most confused of all. Fresh off those pregnancy hormones, it was thick and long and lustrous. Until, that is, I blasted it with six rounds of chemotherapy.
For a long time, all I could think about was what I’d lost. I’d breastfed my first child for 14 months and assumed I’d do the same with my second. But treatment needed to start quickly, which meant breastfeeding needed to stop. In the 10 days before my first round of chemo, I alternated frantic pumping with wistful nursing, gazing at my baby as she fed. In this way, I built up two different stashes, both important: rows of milk bags in the freezer, rows of memories I could return to in my brain.
But 10 days was a luxury compared to the split-second decision I had to make at my first oncology appointment. “Are you done having kids?” the oncologist asked. My husband and I looked at each other, startled. Hadn’t we literally just had one? Who could think about more? She offered the option of an egg retrieval, since chemo would likely fry my fertility, but I declined. We were done having kids; we would’ve been done regardless. Still, the finality of it left a lingering sadness. A door closed and I hadn’t entirely been the one to push it shut.
That tender, fragile period after you add a new baby to the family is disorienting enough — the changing dynamics, the dizzying logistics, the absurd new assignment of getting two children to sleep — but layering cancer treatment on top was like a cruel joke. More than anything, I felt a deep loss of control. I tried to maintain a sense of normalcy for my 4-year-old, but it was hard. I tried to preserve the magic of my baby’s first year, but it was harder. I did a lot of settling. I did a lot of surrendering. I let the A-plus I’d always striven for slip to a solid B. OK, most days it was a B-minus.
But what I discovered is that losing control isn’t permanent — you just hand the reins to someone else for a while. My husband took every night feeding with our daughter, soothed every night terror with our son. Friends fed us unflaggingly during my five months of chemotherapy, and my parents looked after both kids at the drop of a hat. The minute I was diagnosed, the wagons circled. People wanted to help. I tamped down my pride and my perfectionism and I let them.
You will never catch me referring to my cancer as a “journey,” although I do sometimes think of the souvenirs I’ve brought back: gratitude, perspective, a renewed appreciation for the body that betrayed me briefly and then carried me through. But my anxiety is a souvenir too, and it lurks at the edges. When the kids are sick, I fret: is that bruise just a bruise or is it something serious? Is that headache normal?
There’s a saying in medicine: “When you hear hoofbeats, think horses, not zebras.” It means a patient is more likely to have a common, treatable ailment than an improbable, scary one. When I hear hoofbeats now, I go straight to zebras. I’m up at midnight, googling frantically, convinced the worst-case scenario is true. And why not? A terrible thing happened once. A terrible thing could happen again.
Of course, there are solutions to this: Meditation, journaling, Ativan for when the meditation and journaling fail. But the best solution, annoyingly, is time.
In the raw, confusing days after my diagnosis, I texted a friend of a friend who’d gone through a similar ordeal the year before. Would she be up for chatting? I asked. She would, she wrote, but she was about to take her two small kids to Costco. The glorious ordinariness of this knocked me flat. She’d gone through a mastectomy while pregnant, chemo with a newborn, and now she was going to Costco like anyone else? Would there be a day when I, too, would feel normal enough to go to Costco? I couldn’t fathom it. It seemed so far away on the other side.
In a couple of months, I’ll hit the three-year anniversary of my diagnosis. I am grateful to science and serendipity in equal measure. My hair is thick and full again, my scars have all but faded, and yes, I have achieved the ultimate prize of visiting Costco many times (now, of course, in a mask). In the darkest days of chemo, it seemed impossible I would ever say this, but here it is: most of the time I forget I ever had cancer at all.
Still, despite the havoc it wreaked, I can only think of myself as profoundly lucky: that I found it, that I beat it, that I’m here. And while it feels like all I did was just roll with the punches until the punches stopped coming, I hope that one day my kids can look back at my experience and learn something too.
Life knocks you around a little, I will tell them, because that’s what life does. But you pick yourself up and you dust yourself off. You keep going, then you just keep going some more.
Holly Burns is a writer in the San Francisco Bay Area.
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