When Pamela Madsen was first diagnosed with breast cancer in 2007, her life changed in an instant.
As a composer, concert pianist, professor of music composition at California State University, Fullerton, and mother, Madsen was accustomed to balancing a full and vibrant life. Suddenly, her days became focused on appointments, treatments and the decisions that come with navigating cancer care.
She underwent a double mastectomy, chemotherapy and five years of hormone therapy. Through it all, she continued teaching, composing and caring for her family, determined not to let cancer define her.
"I learned that life can change very quickly," Madsen says. "You begin to appreciate things in a deeper way."
For more than a decade, she focused on moving forward. Then, during the COVID-19 pandemic, she received the news she never expected: her cancer had returned.
"I had to face everything again," she says.
This time, the road was even more challenging. Madsen underwent a second double mastectomy, extensive radiation and continued treatment. Today, she is grateful to be in remission, but survivorship brought unexpected challenges that changed the course of her life and career.
Severe neuropathy meant Madsen could no longer perform as a concert pianist, and changes to her hearing affected how she experienced music. For someone who had spent a lifetime performing and creating, it marked a profound shift.
Yet Madsen refused to let those challenges define her future.
Instead, she began exploring new ways to create, teach and connect with others. While she could no longer perform like she once had, her passion for music remained as strong as ever.
"I realized I still had something important to say through my work," she says.
That realization became the foundation for a new chapter.
Inspired by the poetry of Emily Dickinson, Madsen composed Let Me Not Mar That Perfect Dream, a musical work that explores healing, resilience and the courage to imagine a future beyond cancer. The composition premiered this past summer at City of Hope Orange County's Music of Hope survivorship event and was performed by musicians from Pacific Symphony.
For Madsen, the piece became more than a composition. It served as a deeply personal expression of her own survivorship journey and a tribute to the strength she sees in others living with and beyond cancer.
"Cancer affects so much more than the body," she says. "It touches your family, your sense of self and your hopes for the future. The journey is about finding a way to keep living fully while carrying those experiences with you."
Throughout her cancer journey, Madsen found strength in the people around her. Her husband, a fellow musician and cancer survivor, understood many of the challenges she faced and provided unwavering support. Pamela's experience also helped shape her daughter's path. After earning a 2012 Olympic gold medal in water polo, her daughter pursued a career in genetics research, recently completing her internal medicine residency at UCLA.
Together, they helped Madsen navigate some of her most difficult days and celebrate meaningful milestones along the way.
She is equally grateful for the care she received at City of Hope over the years, led by multidisciplinary teams of breast cancer experts including James Waisman, M.D. (retired), and Irene M. Kang, M.D., the medical director of women’s health medical oncology at City of Hope Orange County and an assistant professor of medical oncology and therapeutics research at City of Hope.
"City of Hope treats the whole person," she says. "The care goes beyond treating the disease. It's about helping people heal, find peace and regain confidence in what lies ahead.
City of Hope has long combined world-class medicine with supportive and integrative care, including art, music and other therapies that help patients feel grounded, comforted and whole.
Now nearly two decades after her first diagnosis, Madsen continues teaching the next generation of composers while pursuing new creative projects. She says her experience with cancer has changed how she views both life and art.
Instead of focusing on what she lost, she chooses to focus on what remains possible. That perspective has given her a deeper appreciation for everyday moments, meaningful relationships and the opportunity to continue creating music that connects with others.
She also hopes her story reminds fellow survivors that there is life, purpose and joy beyond cancer, even when the path forward looks different than expected.
"As survivors, we share a bond," she says. "We've all faced challenges that have changed us. But I've learned that healing isn't just about recovery. It's about discovering who you are now and finding a way to move forward."
Today, Madsen remains inspired by the resilience of her fellow cancer survivors and the extraordinary support of family members, friends and caregivers who walk beside them along the way.
"I'm grateful for every day," she says. "I'm grateful for the people who helped me heal, find peace and discover that even after cancer, it is possible to dream again."
Ending Cancer Starts with Hope. 888-333-HOPE (4673) | CityofHope.org/OC
Talking Hope: How to choose the right doctors and cancer center for your breast cancer surgery
5 reasons why breast cancer screenings are crucial to women’s health
4 Helpful Steps to Take After an Early-stage Breast Cancer Diagnosis