Overexpressed

At 9:59 am on 12/31/2019, my oncologist, whom I have known for the last seven years, acknowledges the observations on my CT chest scan with an attending radiologist.

I imagine the phone conversation between these two people is full of silences as they both gaze at my interior landscape.

Soon after this conversation, my oncologist calls me on the phone. I am in the yard, back by the fence in the muddy grass.

When I pick up the phone, I listen to him—voice mannered and factual—tell me that what we have both thought is a slow to heal yoga injury is metastatic breast cancer. I imagine that as he tells me this, he removes his wireframe glasses and rubs his face; he looks down rather than out his window into the gray New Year’s Eve morning.

At the end of our conversation, I notice how unusually warm it is and how muddy my feet are. I take a deep breath and awkwardly thank him for calling.

Metastasis

In Greek, metastasis means “removal, migration, dislocation.” In medicine, metastasis means “transference of the seat” of the disease.

In 1843, Dr. DB Slack explored the connection between metastasis and sympathy, which means “the suffering or affection of two separate parts of the body at the same time.” His findings are published in the Boston Medical and Surgical Journal. One is titled “Sympathy-Metastasis” and the other “Metastasis-Sympathy.” 

For me, it means that some of my original breast cancer cells—which were not eradicated by chemotherapy and other treatments in 2012—traveled through my bloodstream, and after seven years, began to grow again.

And on their journey, those cells found their sympathetic home in my bones.

Overexpressed

Between 20%-30% of women who have been diagnosed with early breast cancer will later be diagnosed with a recurrence. 

And of that 20%-30 %, about 10%-20% are HER2 (human epidermal growth factor 2) positive breast cancers. 

Basically, in every healthy breast, there is a HER2 gene that makes HER2 proteins. These proteins act as receptors on the outside of breast cells and control how healthy cells grow, divide, and repair themselves.

In HER2-positive breast cancer, the gene mutates and makes too many copies of itself. As a result, the over-amplified HER2 genes tell the HER2 proteins to grow and divide uncontrollably. They are overexpressed.

Too many women know the space between hanging up the phone and turning to partners, children, parents, siblings, friends, colleagues, other women who worry about recurrence, neighbors, and strangers to tell them that what they think is something else—in my case a slow to heal yoga injury—is metastatic breast cancer.  

Not curable, metastatic breast cancer is treated as a chronic disease. Many are living longer, healthier, happier lives, but many are not.

Called “wildly HER2 positive,” I created this blog–weekly posts that may include poems, articles, interviews, essays, reflections, heartbreaks, and joys–to be a vehicle for transforming suffering into healing, a place to share my story and others’ stories, too. 

New Year’s Eve 2021

Many years ago before my initial breast cancer diagnosis, I wrote a poem titled “New Year’s Eve.” At the end of the poem, I write:

For many the last day of the year
has the scent of lemons,
a divine prophecy:
you will be sent a boat
upon which you must sail. 

Today I set sail. Though I am not sure where this journey will lead me, how I will navigate turbulent waters, or what I will discover along the way, I invite you to come along for the adventure. Share your wisdom. Share your story. Write to me. Question me. Let me know what it means to you to be fully alive and living.