Women

Lessons on Cancer Survivorship From the Front Lines

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From the age of 4, Cheryl Law, MD, 41, knew that she wanted to be a doctor. Her parents, the first in their families to complete college, had moved from rural Alabama to pursue careers near Birmingham, where they raised Law and her brother. She often was the only Black girl or Black kid in the classroom, an isolating and lonely experience. But her drive and determination helped her realize her childhood dream: After attending Alabama State University, a historically Black university, she earned her medical degree in 2008 from the University of South Alabama College of Medicine and became the first doctor in her extended family—and one of the very few (2.8%) Black female physicians in the United States.

In 2014, Law married Rodney Bey, and they settled outside Birmingham, near her hometown. She joined two doctors in a Hueytown practice, taking over for a third retiring physician. Law entered the practice, her first job after family medicine residency, “with all of these dreams and hopes of how life would be, now that I was done with my training,” she says. “My parents had stayed in the same profession and worked for the same companies for 20-plus years. So I thought that’s how life would be for me—you get your job, you work there forever, you retire from there.”

Cheryl Law

In short order, she and Bey had three kids—Josie, 8; Rodney, 6; and Joy, 5. “We were pregnant about a month after being married, so marriage, pregnancy and kids were all wrapped up in one,” she says. To make things work with Law’s busy doctoring schedule, Bey stayed home with the kids.

In the spring of 2018, at a postpartum exam six weeks after the birth of Joy, Law told her doctor that her left breast was inflamed and painful—due to an infection from breastfeeding, she figured. But an ultrasound, mammogram and biopsy said otherwise: The diagnosis was triple negative breast cancer, a rare breast cancer subtype. Law had just turned 35. She and Bey were silent with shock when they received the news while driving the family car. “How could this really be us? Not in the prime of our lives, not when we’re having these babies, not when we’re talking about family trips and our future,” she recalls thinking. With no previous major health problems, “I just never would have considered that breast cancer would be my introduction to having health issues.”

Triple Negative Treatment

Triple negative breast cancer is so named because this subtype’s cancer cells have no estrogen or progesterone receptors and make little if any HER2, a protein that spurs tumor growth. It’s more common in women under age 40; it grows and spreads faster than other breast cancers; there are fewer treatments; and Black women have nearly triple the risk of other women. Given these realities and concern over some of Law’s lab scores, she and her oncologist discussed the option of her joining a drug trial. Law was hopeful that she would get into the experimental arm of the I-SPY 2 trial, which tests new treatments aimed at shrinking locally advanced breast cancer, but “I ended up getting standard of care,” she says. That regimen was AC-T, which consists of Adriamycin (doxorubicin), Cytoxan (cyclophosphamide) and Taxol (paclitaxel).

Law started chemotherapy presurgery to try to shrink the tumor, all the while continuing to see patients—taking a day off on Mondays for infusions and heading to work the next day. “I did fairly well with A and C, but the T was really tough. That’s when the hair loss started, the extreme fatigue,” she says. “But it was not working for my cancer. That was even more terrifying.”

She stopped chemo early, and on Juneteenth—June 19, the day in 1865 that enslaved Blacks in Texas were freed by executive decree, two years after the Emancipation Proclamation—she had a mastectomy to remove her left breast. “That being the day of freedom, I thought, I’m being released from having this breast cancer on that date.”

Law’s demanding workload and parenting—the “good distractions” in her life—took over once more as she recovered from surgery, started on an oral chemotherapy regimen and hoped to put breast cancer in the rearview mirror. “I wanted to be strong and move through [the cancer experience]. So I had the perspective of, ‘You can get through cancer and it’s done.’”

Cheryl Law

From the Breast to the Brain

Bey and Law celebrated their fifth wedding anniversary (which also coincided with Law’s birthday) at the end of April 2019. Soon after, Law began having pain around her cheekbones and one eye. She sometimes had seasonal allergies, so she treated herself for a sinus infection. But a good friend from medical school who happened to be an oncologist suggested that Law get a brain scan “just to be certain there isn’t something going on in your head.”

But there was—an MRI revealed that Law had metastatic breast cancer (MBC) that had spread to her brain. The devastating diagnosis coincided with the departure of her first oncologist, “a male physician who always exuded hope and optimism, who would put his hands on me and smile.” Now a new, female physician was telling her, “You need to stop working, go home and spend as much quality time as you can with your family.” The bleak message resonated with Law. “This was different,” she says. “I was fully aware that this is a lifelong issue, and now my life may be shortened because of this diagnosis.”

Brain surgery was scheduled on another special date: June 6, Law’s parents’ wedding anniversary. Part of her left frontal lobe had to be removed in order to extract the tumor during a surgery that took just four hours instead of the predicted six to eight hours—“a miracle,” Law says. A small stroke she had during the operation left the right side of her body weak, including her right leg. But one of the things she’s grateful for is that the surgeon didn’t have to mess with her hair. “Hair is something that’s important to Black women—and all women, I would say.”

Since the surgery, Law has been on an anti-seizure medication and an oral chemotherapy agent. She has brain MRIs and lab work every three or four months, chest and pelvic CT scans once or twice yearly, a yearly mammogram and other tests that her physician team recommends. There have been ups and downs, but recently, she has been doing well.

Physician, Heal Thyself

After the MBC diagnosis in 2019, Law took her oncologist’s advice and left her medical practice to spend more time with family. In retrospect, she saw that her heroic attempts to balance a demanding workload with a new marriage, three children in quick succession and parenting had been far from optimal. “I was on such a journey to think about healing others that I didn’t even think about the fact that I needed to help myself,” she says.

She realized that she needed to acknowledge that her emotional well-being was important, that her sleep was important. “You’re telling everyone else they need to eat well and sleep well. What about you?… You don’t need to rush to everyone’s aid. You don’t have to say yes to everything. You don’t have to—you can’t.”

The past few years have been a time of exploration, “finding that I still have worth and that I’m still able to use my medical knowledge and my experience as a patient without feeling overwhelmed,” she says. She has also looked at her daily regimen and now eats more veggies and fruit, drinks more water and walks more. And “there’s a lot of thoughtfulness about the plans for the kids, like what’s next in terms of their schooling. I’m trying to just impart knowledge and wisdom with them as I can.” She takes time to explain science, which she wants them to like “the way mommy does—or at least have an understanding about it.”

Law has gone on a couple of retreats that have been “amazing—the connections are helpful and healing for me. I feel less isolated after meeting others with MBC.” She was asked to join the board of Cancer Culture, an organization founded by people with breast cancer who want to bring awareness to breast cancer issues, especially ones that are overlooked, like MBC research. She’s also on the Cancer Patient Family Advisory Council at the O’Neal Comprehensive Cancer Center of UAB Medicine, where she consults on hospital initiatives that help patients access services at the hospital, and is a young advocate for Living Beyond Breast Cancer, a nonprofit that connects people to information and support. Law helped organize LBBC’s annual conference this year.

She finds it tough when people ask how she’s doing because there are so many ways she could respond. “I could focus on all the things that are going wrong,” Law says. “The aches and pains and the weakness and the memory loss and things like that. But I’m here. There’s so much to be grateful for. I’ve got these kids I’m surrounded by. And I’ve got so many parts of my body that are still functioning better than many would expect. I have a spiritual belief and faith that I know is keeping me around. And I’ve got love and hope; let’s leave it at that.” 


SIDESTORY

Cheryl’s Laws

Life-affirming advice from a metastatic breast cancer survivor

  1. You have to have hope. “I really have gathered a lot of hope from my grandmothers, who both lived to be over 100.”
  2. Draw strength from others. “I had a 90-plus-year-old patient who’d had cancer, and it recurred. She still had a hope and faith and a strength that was amazing. It didn’t seem like cancer ruled her life.
  3. “Relationships are so important. I needed the medical knowledge of someone else [her oncologist friend] to help me recognize when I needed a brain scan.”
  4. Speak up for yourself. “Speak on your concerns and issues, including financial ones. Your physician should be documenting what your issues are—documentation is important as it relates to change and improving health equity.”
  5. Or find someone else to be your voice. “In my practice, I had little old ladies who needed their granddaughters to come with them and explain what was going on in real-talk ways.”
  6. Accept help. “Some of my Sigma Alpha Iota sisters [a music sorority] from college helped me clean up my house. I was embarrassed, but they said, ‘We’re here to care for you.’”
  7. Find your community. “Find folks who appreciate you. That can change with different stages in your experience. Some people liked Cheryl better without cancer; some like Cheryl with cancer. It’s so easy being comfortable in the MBC community. We have less of a filter. You put things out there, and they get it.”
  8. Trust that there is more support than you’re aware of. “There are folks in hidden places that have been taking care of me, praying for me and loving on me. It’s not always who you see that’s there for you.”

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