Jessica Galloway hates to be called a 'cancer survivor.' It's been four years since she began her battle with breast cancer, and she feels healthy and strong, but the thought that her cancer might return is never far from her mind, and she resists the label of conquering hero. "I don't know that I will survive breast cancer," she says.
But you could certainly call her a fighter. Once diagnosed, the former competitive ski racer attacked her disease like she might have tackled a ski course: with all the effort she could muster. In addition to undergoing chemotherapy, radiation and a mastectomy, she signed up for two research studies. She's also become an advocate for UCSF Medical Center and its proposed new Mission Bay hospital, part of which will be devoted to cutting-edge cancer treatment, as well as a support and resource for other breast cancer patients.
Four years ago, she wouldn't have imagined such a life. Athletic and health conscious, the nurse practitioner 'did all the right things,' exercising and eating well. Just 40 years old when diagnosed, with three small children ranging from 9 months to 4 years old, Galloway was stunned to learn she had cancer. "I felt like my body had betrayed me," she remembers.
The only warning sign — a lump in her right breast — was initially diagnosed at another hospital as a blocked milk duct. Nine months later, after reexamining her case, the doctor called her back in. "They asked me if I could come in that afternoon, and I said no. Then they asked me if I could come in the next morning, and I said no," she says. "And by the time they asked me if I could come in tomorrow afternoon, I was like, Oh my god, something is very wrong. And when I went in, I could read the concern on their faces." After performing an ultrasound and mammogram, they told Galloway that she had a very suspicious mass in her breast.
At that point, with her medical charts in hand, Galloway called the UCSF Carol Franc Buck Breast Care Center and asked for an appointment that afternoon. "UCSF is at the forefront of medicine, certainly in northern California for breast cancer," she says. "It was an obvious choice." She went in for a biopsy, and a few days later, met with Dr. Laura Esserman, a breast surgeon and the director of the center.
Esserman delivered the news that Galloway had locally advanced breast cancer, an aggressive form of the disease that tends to have a worse prognosis. "Laura was amazing," says Galloway. "She held my hand. Not only was she a great surgeon, she was a great friend. I really felt like the most important patient she'd ever had."
Galloway's doctors recommended that she begin by taking part in the I-SPY research study, in which volunteers with breast cancer received chemotherapy before surgery, and the tumor's response was monitored with magnetic resonance imaging (MRI). Called neoadjuvant chemotherapy, this type of treatment is becoming the standard of care for patients with locally advanced breast cancer, says Esserman.
In Galloway's case, however, after four months of chemotherapy her tumor had shrunk very little. "It was huge — 5 by 7 centimeters," she says. In August of 2005 Esserman performed a mastectomy on Galloway, which they followed with six weeks of radiation.
As her treatment was wrapping up, Galloway asked Esserman and her oncologist, Dr. Mark Moasser, if there was anything else she could possibly do. They mentioned another clinical trial they were planning to begin at UCSF, which was already in progress at the Dana-Farber Cancer Institute in Boston. The study was testing whether a drug used to treat colon cancer could prevent breast cancer from metastasizing, or spreading, by killing cancer cells traveling from the tumor site to invade the rest of the body. But to qualify for the trial, Galloway needed to start the drug soon after finishing radiation. She flew to Boston twice to start the trial, then finished treatment at home once the trial began at UCSF.
One of the most intense moments of her treatment occurred not at UCSF or Dana-Farber, but on Mount Tamalpais in Marin. When she got sick, Galloway created a ritual of regularly hiking a four-mile trail on Mt. Tam. Though she hiked more and more slowly as chemotherapy progressed, the walk became a lifeline of sorts, a way to hold on to the feeling of being a strong, active participant in life.
"It was a totally windy day, and my hair had started to fall out," she says. "Though I had a fairly healthy head of hair when I started, by the end of the hike, I hardly had any hair at all. It was sad, but it also felt so part of what I was going through that my hair blew off in this place that I loved." Arriving back at the car nearly bald, she put on a hat and continued on to her oldest son's kindergarten orientation. "Here were all these other people I was going to meet, other parents, and I felt very conspicuous," she says. "I felt like a cancer patient. I couldn't really blend in any longer."
Her hair has long since grown back, but in many ways, Galloway still feels like a cancer patient. She takes medications that she and her doctors hope will prevent her cancer from coming back, and is reconciled to the fact that, most likely, she will always be in treatment for cancer. She's less reconciled to the one question that's never far from her mind: Will it come back? Four years ago, her doctors told her that the chance of her cancer becoming metastatic was greater than 60 percent. Now the likelihood has fallen to 25 percent.
While time passes and her chances improve, Galloway definitely doesn't refer to breast cancer as a closed chapter in her life. "When I was going through treatment, there was not a second of any day that I didn't think about breast cancer," she says. "Now, I wake up in the morning and it's not the first thing that I think of. But it's very much part of who I am." Who she is looks a lot like the old her, she says, only in sharper focus. "Cancer makes you realize who your friends are, what your priorities are," she says. "You lose fears about things that are completely irrelevant."
She is also now a point person for other women who've been diagnosed with breast cancer, and often shares some of the first advice she got from Esserman: "This is not an emergency. You do not need to make the decision today. You have to slow down, take a deep breath and start collecting information." Because the amount of information can be overwhelming, Galloway recommends that cancer patients never go to a medical appointment alone. "Find one person who is competent, thoughtful and organized to help you pull all the information together," she says. "It could be a friend, a relative or someone from UCSF's support program."
One reason Galloway welcomes the chance to talk about her experience and counsel other patients is the chance to be up-front about a topic that can otherwise get swept under the rug. "Our culture is so obsessed with health and perfection that people seem to think that if you've had a disease, you've somehow failed," she says. "That is so ridiculous. It's bad luck, but it's not a failure. You don't do something unethical to get cancer. And if you're open and honest about it, it feels a lot better."
It's that honesty that makes her resist the term survivor, and any implication that out of sheer strength and persistence, she won a battle that others have lost. "I'm very proud of how hard I fought, but a lot of my outcome was because of luck and good treatment," she says. "I feel so lucky and grateful."
Story written in September 2009.
Sierra Tzoore is a freelance writer in San Francisco.
Carol Franc Buck Breast Care Center
1600 Divisadero St., Second Floor
San Francisco, CA 94115
Phone: (415) 353-7070
Surgery Fax: (415) 353-7050
Oncology Fax: (415) 353-7692
Radiation Oncology at Mount Zion
1600 Divisadero St., Basement Level
San Francisco, CA 94143-1708
Main Phone: (415) 353-7175
New Patient Appointments: (415) 353-9807
Fax: (415) 353-9884