PLANNING FOR THE UNPLANNED
By Hanh Nguyen, Ph.D.
As a biotech project manager and former breast cancer researcher, Hanh was used to juggling multiple assignments. But breast cancer diagnosis and treatment became the most difficult projects of her life.
About 1 in 8 women (U.S.) will develop breast cancer over the course of her lifetime. Throughout my graduate education at UC Berkeley, this was the opening line for presentations that I gave on the anti-tumor effects of indoles, which are naturally occurring chemicals found in vegetables such as broccoli, on breast cancer growth. Little did I know that on April 28, 2011, I would be added to the estimated 230,480 annual new cases of invasive breast cancer expected to be diagnosed in women in the U.S., or that I would contribute to the 5-7% of women diagnosed under the age of 40 (breastcancer.org).
That spring, it started with a sharp pain on my left breast in the middle of the night. I searched for a lump with each shooting pain, but found nothing until the pain caused me to turn sideways one morning. Then there it was, a slight but noticeable lump. It was supposed to be a quick checkup with my primary care physician, but turned into a whirlwind of tests, scans and consultations in the weeks thereafter. The technical jargon of breast cancer research I once used in my presentations suddenly became a permanent part of my identity, when the biopsy results confirmed ER-/PR-/HER2+ invasive breast cancer.
My familiarity with the disease helped me to make informed decisions on my treatment plan. However, I wasn’t prepared for the onslaught of doctor’s appointments, tests, scans, consultations and surgeries in the months and years following my diagnosis. A daunting task was the challenge to schedule the fight against cancer into my already busy life. Though clearly a priority, I made a quick decision not to let cancer take over my life: I had just accepted an exciting position at a new company (and sent in my letter of resignation to my previous employer three days prior to my diagnosis), had plans to sell my house, find a new home and to start a new job in June while my husband would start medical school. The timing was not ideal but as a project manager in the biotech industry, I told myself that this was doable and immediately began to plan my strategy. As I made new friends throughout the lengthy chemotherapy sessions, I realized that having so much to do (in order to ensure that I had a life to return to) was a blessing in disguise, since I had very little time to fall into and wallow in an emotional slump. Despite the physical and emotional challenges associated with chemotherapy and surgery, I remained optimistic and happy, and was able to stay engaged in life.
Finding Life Balance
When asked how I managed to maintain my life and career despite cancer treatment, in retrospect I would say that there were three essential components. First, you must have an optimistic outlook and a strong will to live. Second, you need to be informed and proactive about your own healthcare (be your own advocate), and third, you need a strong support structure (whether it be friends, family or co-workers).
After the initial shock and eventual acceptance of the uncertainties associated with a cancer diagnosis, my project management skills immediately kicked into full gear as I outlined the key activities that needed to be done, made arrangements with family and friends for necessary support, and had the appropriate discussions with my employer at the time. Next was contacting my insurance companies and my new hiring manager to ensure that all pertinent parties were informed and aligned with my own timing and plans for treatment and move. All of this had to be settled before my surgery, which was scheduled two weeks after my diagnosis. By the time I was laying on the operating table, it finally dawned on me that my life will be forever changed: I will no longer have my breasts, and was certain that I would require treatment for an extended period of time. It was in these vulnerable moments that I fully allowed myself to just let go of everything and cry. The bilateral mastectomy was an eye opener on pain management (or the lack thereof in my particular case). I woke up from surgery with searing muscle pain that tore through my body as they attempted to move me from the gurney to my hospital bed. The standard pain medication was ineffective and for the coming days, I was kept on a morphine drip as the care unit sought to identify pain medication that would work without inducing an allergic reaction. My sister, a talented pharmacist, was the person who finally gave them the recommendation for the most effective pain management strategy, which enabled me to leave the hospital. While in the hospital, I learned that I had to be my own advocate to get the relief that I needed and to catch mistakes that were made due to knowledge gaps by the well-meaning medical staff regarding my condition. It’s important to keep in mind that though the medical staff is trained, they are also human, and each case and patient is different. It is crucial for patients to be informed and fully understand their medical history, what treatments are needed, and to be vocal and proactive in ensuring that care providers are informed and are providing the appropriate care.
Continuing to Plan for the Future
For the following eight weeks, while managing other segments of my life, my next trial was when I sought a balance of listening to my body and respecting its need for rest. In the process of selling my house, I found that humor and an upbeat attitude was all that it took to make a normally awkward situation more pleasant: I tried different approaches to explain to the potential buyers why I was in bed with drainage tubes hanging out from my sides during the house viewing. As soon as I had recovered my strength and was able to endure a car ride without pain, we moved to Los Angeles. I started a new job, and was able to build my care provider network (local oncologist, plastic surgeon, liver specialist, cardiologist, gastroenterologist and neurologist).
These comprised the panel of experts who cared for me through the months of chemotherapy, which was a humbling experience in many ways. It was challenging (physically and mentally) to adjust from being a marathon runner to a cancer patient who can barely make it up a flight of stairs. Despite the discomforts (a topic too vast to cover in this article), I was able to adjust to the physical limitations of my body with the help of a very supportive husband and a wonderful group of friends and coworkers who gave me encouragement and reassurance on a daily basis. I’m happy to report that I’m cancer free today. Though I’m still undergoing treatment and have reconstructive surgeries scheduled in the road ahead, I’m grateful for the life that I have and look forward to all the great things to come.
Hanh Nguyen obtained her Ph.D. from the University of California, Berkeley, and has been climbing the corporate biotech ladder ever since.