The year 2008 started out promisingly for Carol Duran. At 43, she and her husband, Jaime, were enjoying the daily adventures of raising their rambunctious 3-year-old twins, James and Julian. Now that the boys had been accepted into preschool near their Alhambra, Calif., home, the paralegal planned to return to college to finish her degree. “Then, it all came crashing down.”
Duran felt a lump in her breast yet a mammogram revealed no abnormalities. Having fibroadenomas (benign breast tumors), she had undergone regular mammograms for years, and was diligent about checking herself for lumps. This one concerned her, though, and she asked to be retested, overruling her doctor’s suggestion to wait six months. After another mammogram, an ultrasound immediately revealed a lime-sized growth. A biopsy confirmed it was malignant.
"The first thought was, 'I'm going to lose my life, and leave my kids without a mom,'" Duran recalled through tears during a recent KNBC interview.
She came to City of Hope in 2008, under the care of Stephen J. Forman, M.D., the Francis and Kathleen McNamara Distinguished Chair in Hematology and Hematopoietic Cell Transplantation at City of Hope.
Duran was diagnosed with HER2-positive breast cancer, an estrogen-driven cancer that’s particularly aggressive, and underwent chemotherapy, a mastectomy and reconstruction. "Literally, they gave me hope to think I was going to get through this, that I was going to be here for the long haul and see my children grow up," she told KNBC.
She received much of the treatment as an outpatient, enabling her to return home most nights to her children. “It was nice to be able to come home even though I wasn’t feeling that great. At least my boys could climb into my bed or I could sit on the floor and play with them or read to them. I was with them a lot, which was important to me. In case something happened, I wanted them to remember me.”
That was nearly five years ago and today Duran is healthy, back to work and she and her husband are enjoying new adventures parenting their 8-year-old boys who are in the third grade.
“Fear of recurrence is always in the back of my mind, but I don’t let it rule my life,” said the now 48-year-old Duran. “You can’t let it debilitate you where you can’t do anything or feel like you can’t live your life.”
Next March, to mark her fifth cancer-free year, she and her husband are planning a celebration to suitably commemorate the occasion.
“We’re thinking about having a party called ‘I kicked cancer’s ass,’” she said with a laugh.
We recently asked Duran to look back at the time of her diagnosis and ask herself, what do you know now that you wish you’d known then? What wisdom, soothing words or practical tips would you give your newly diagnosed self?
Trust your instincts. If you’ve got a gut feeling something’s wrong, see a doctor. Get a second opinion if necessary, and don’t delay. Nobody is going to do it for you. It’s also really important to know your body so you can tell when something seems abnormal. It’s always scary to think there’s something wrong, but it’s better to find out while something can still be done about it. Insurance companies will often only pay for a mammogram once a year. I said, "I need to be retested and I’ll pay for it." When I talk to my sisters, girlfriends and other women, I tell them you have to be your best advocate.
Ask questions. When women go in for mammograms, one of the things they need to ask their doctors is, "Do I have dense breasts?" When you do, a lot of times mammograms can’t detect malignancies. If you’re a woman with dense breasts, ask for an ultrasound even if you have to pay for it. My tumor was the size of a lime – a large lime not a key lime – and they missed it. They said one of the reasons was I had dense breasts. With the ultrasound, they saw it immediately.
Bring a companion to appointments. When the doctor tells you something, you hear it, but you don’t really register it. My husband would write down everything. Also, I’m the kind of person who, when they hear about side effects (like your throat will close or you’ll get hives), manifests these things. Doctors and nurses need to tell someone about the side effects, but patients have enough to worry about. In some cases, I think they should just tell the caregiver and not the patient, so you don’t stress about side effects that may not happen.
Buy a wig – before your hair falls out. I thought I would be special and my hair wouldn’t fall out. That wasn’t the case. My hair came out in clumps the first round of chemotherapy. I was totally unprepared. It affected me in a way that’s kind of unexplainable. You have an identity of what you look like then when you lose your hair and eyelashes you have that "chemo look." You don’t realize how it really affects your psyche and how you perceive yourself. Be aware that you may lose your hair, and get fitted with a wig that you like now rather than going in bald. When you’re going through treatment, the less stress you’re under the better.
Don’t rush into reconstruction. I had tissue expanders after the mastectomy, but kept them in longer than I should have. I wanted to get some distance. Sometimes women feel too rushed to have reconstruction done. If you’re OK with it, wait. What’s the rush? I think you need some time to heal from everything your body has been through, and all that trauma. I felt like I needed some time so I took it. Finally, I had the expanders removed, and the permanent implant put in.
Seek therapy after treatment. When you’re in treatment, the emotional cracks don’t show until later (six months in my case). When I was still receiving Herceptin and undergoing reconstruction, that’s when the realization of what I had gone through hit me. I just needed some help, to know that it was OK to feel what I was feeling. I remember thinking, "I beat this, but something else would get me." I started not wanting to go out. It’s important you have a good relationship with your oncologist. I immediately went to Dr. Forman and said, "Something’s wrong. I’m scared all the time." It was all emotional, coming to grips with everything I had been through.
Next: Carol Duran on parenting, relationships and daily life.