Authors: Nancy G. Brinker
“Mom, when I’m gone … you have to hold on to Eric.”
“We’ll both hold on to him. You’re not going anywhere.”
“I’ll never have a baby with Norman. We were just getting started. Getting each other figured out. I love him so much, Mommy. What if he looks at me tomorrow and … what if he doesn’t think I’m beautiful anymore?”
“He knows what’s beautiful about you, and it’ll still be there.”
“He’s already been through this once, and it tore his heart out. I can’t stand the thought of doing it to him all over again. I can’t stand hurting you and Daddy … leaving Eric … letting Suzy down. I promised her it would be different, and now here I am. Nothing’s changed.”
“Everything has changed,” said Mommy. “You’ve changed. That’s how I know you’ll be all right.”
I vaguely remember being wheeled into the operating theater early the next morning. Before they put me under, I touched my breast. I didn’t feel warlike. I certainly didn’t see my breast as the enemy. I felt mournful, and my breast felt soft as a rose hip. I tried to touch it one last time as I felt myself drifting away, but when I lifted my arm, it was as heavy and numb as the stone wing of a cemetery angel. The dulled tips of my fingers found the edge of a bandage and some plastic tubing.
It was over.
I’d taken that first terrible step toward survivorship.
B
RIDGET
M
OONEY
S
PENCE
walks with purpose. Still in her twenties, she’s come a long way, and she has every intention of going a lot further.
Growing up with three brothers, Bridget was as rough and tumble as she needed to be, but firmly grounded in girly-girlness in the tight-knit community of the all-girls school she attended in Baltimore. It was a loving sisterhood, and Bridget’s upbringing—like Suzy’s and mine—instilled in her a sense of stewardship. When she was in high school, she and her classmates participated in a Race for the Cure. Bridget remembers it as a lot of fun, everyone in pink, feeling good about the day, but she and her friends didn’t take much notice of the survivors at that event. Those were mothers and teachers, older ladies—the ones who get breast cancer—and Bridget and her friends were busy being young and invincible. Which is exactly as it should be.
Bridget went on to Boston University to study international relations. Her dream was to travel the world in the Foreign Service, and the opportunity to study abroad during her junior year brought maturity and clarity to that vision. She experienced Europe with the same thrilled appreciation Suzy and I did and returned to Boston for her senior year in 2003.
She wasn’t hypervigilant about doing a monthly breast self-exam. Why would she be? She was only twenty-one, not in any particular high-risk pool, no family history of breast cancer. But with all the reminders—all that pink flapping around every October—Bridget gave it a casual go once in a while, and one morning in the shower, she did feel something peculiar.
“The Mooneys don’t get sick,” she says. “We never go to the doctor.
I didn’t even have a doctor in Boston. Mom made my regular appointments at home during vacation.”
But when the small, firm lump didn’t go away, she did confide in a friend, who encouraged her to go to the public health clinic for an OB/GYN exam. Bridget was reassured that this was a fibroma, nothing to worry about at her age—certainly not breast cancer. A mammogram was deemed unnecessary.
Bridget’s biggest worry that semester was where to go for spring break. With all her credits nailed down, she was antsy for graduation, and she was six months into one of those euphoric First Great Romance sort of relationships with a tall, red-haired New Englander named Alex Spence. They’d said the
L
word. Life was good. But by the end of the school year, Bridget’s stomach was unpredictable and her energy low. The lump in her breast, barely detectable at first, was clearly palpable now, almost protruding. She’d begun to notice a vaguely yellow cast to her complexion, a subtle warning of the cancer that had metastasized to her liver.
“I didn’t know what jaundice is,” she shrugs. “I kept thinking I was partying too hard or maybe had mono—the kind of stuff they tell you to worry about at this age. STDs. Stuff like that.”
When Bridget’s family arrived for graduation, her mother was startled and deeply concerned. She consulted the head of Johns Hopkins and had her daughter on the next flight to Baltimore. Arriving at the hospital with orders for an ultrasound and mammogram, Bridget was asked, “Why are you here?”
“They kept giving me a hard time,” she says. “Everyone kept saying,
This isn’t right. You’re too young.
”
Bridget was diagnosed with Stage IV breast cancer. (And it
isn’t
right. She
is
too young.)
“I’m well spoken, and I have a good handle on my emotions,” she says. “I got through all those conversations just fine, but when I went to tell Alex, I was a blubbering mess. He’s a button-down guy, a New Englander—not a gusher—but he scooped me up and let me cry, and then he said, ‘Put on a party dress. We’ll go out to dinner and talk about how to deal with this.’ He’s a high-school English teacher, God love him, so he has summers off. He moved into my parents’ house and became best friends with my brothers.”
“The first step is chemo,” her oncologist told her. “We’ll operate later. If at all.”
The possibility of a cure didn’t even enter the conversation; the objective was to keep her alive as long as possible, and the clear assumption was that she would be on some kind of chemo regimen for whatever time she had left.
“The worst part for me was having to move home,” Bridget sighs. “I love my family, but I felt like such a dork, hanging out with my parents.”
She started Adriamycin in combination with Taxol; results were immediate and better than expected. The tumor in her liver shrank to the extent that all visible traces of cancer completely evaporated from scans. After a lumpectomy and an intense course of radiation, Bridget went on Herceptin—a brand name for trastuzumab—a powerful new weapon in the breast cancer arsenal.
Herceptin is a monoclonal antibody therapy that uses ingeniously engineered molecules to create a smart little drug that attaches to specific defects in a cancer cell and mimics the natural immune response. Because cancer is essentially part of the host’s body, the immune system—which is designed to spot and attack invaders—doesn’t recognize it as dangerous. Monoclonal antibody therapies recognize cancer, attach to and re-program growth receptors on the cell surface, and deliver radioactive particles that kill the cancer cell without damaging healthy cells nearby, which means the side effects are nothing like the havoc wreaked by treatments that are, of necessity, highly toxic.
The cancer cell is like a serial killer hanging out in a bar; he just blends in with everybody else. Herceptin walks in and
—hello
—knows him immediately for what he is. She lets him buy her a martini, takes him out for a tango, slips a toxic Mickey in his drink when he’s not looking, and—
bam
—one less serial killer on the dance floor.
While Bridget was growing up, controversy swirled around clinical trials for this promising drug. Women who’d come to the end of their treatment options were frantic to get in; families tried to go over and under the table, angling for the right slot in the double-blind studies. Researchers (funded in part by SGK) fought to keep it all by the book, laboring through the rightly rigorous process of getting the drugs approved, available, and insured.
“I thank God every day for the people who took Herceptin before me—everyone who made it possible,” says Bridget. “I felt like I’d bought myself some time. They were still negative. ‘Oh, you won’t live ten years.’ But I felt positive.”
She set out to get her life back: got an internship at a magazine, went to visit friends in New York, and landed a corporate job as an IT recruiter in Boston. Before she left home again, Bridget and her family threw a giant party, inviting everyone who’d sent her a card since she started chemo. It wasn’t a going-away party; it was a celebration of moving forward.
A month later, the cancer in her liver revealed itself again.
Bridget attended her first Race for the Cure as a survivor in 2005 and connected with other young survivors, including Deb Kirkland, who started Breast Friends in Baltimore and later traveled with me to Budapest for the Global Advocate Summit. Our Baltimore affiliate was started by my stepdaughter, Brenda Brinker Bottum, whose mother—the famous tennis champion Maureen “Little Mo” Connolly—died of ovarian cancer at a heart-wrenchingly early age.
It’s a small world for young survivors.
In this company, Bridget felt comfortable in her own skin for the first time since she was diagnosed. She hadn’t even considered going without a wig before this. Deb immediately saw the potential in this bright, beautiful girl who was so able to articulate the challenges specific to young women with breast cancer—including the obstacles that delay diagnosis with catastrophic consequences.
“I want to take you to the sororities,” she said. “They’ll listen to you, and they need to hear that breast cancer isn’t just something that happens to your grandmother.”
Bridget got involved, stuffing envelopes, speaking to college students. She liked the IT job well enough, but started looking for an opportunity to become something more. In 2008, she decided to take on the Susan G. Komen for the Cure 3-Day event in Washington, D.C., and loved it so much, she turned around and did the San Diego 3-Day, walking a total of 120 miles to raise $6,000. Two weeks after she crossed the finish line, she and Alex Spence were engaged. A few weeks later, the cancer recurred in her lymph nodes.
“The fairy tale is supposed to be different.” She talks about her lost innocence with some sadness and a thin edge of anger, but no bitterness. “I had to wake up to the fact that this happy ending I kept banking on was not going to happen. This isn’t going to go away, but that doesn’t mean we can’t have a full and happy life together.”
“I’ve integrated it into my life,” says Bridget, “and I think I can keep it up for a long time, but I hate when people use the word
chronic
or compare it to diabetes. It’s not like that, where you can find a baseline and maintain it. This is periods of
Hey, it’s okay
and then fever-pitch emotion—this foreign thing is growing in you. I beg them to find some way to buy me another eighteen months, and somehow they do, and then we start all over again. I’ve managed to find a purpose in it, but I hurt for Alex. Who would choose this?”
Alex’s answer to that question: “You don’t choose who you can’t live without.”
The nodes were removed, and Bridget finished chemo just before the wedding. The two enjoyed an idyllic honeymoon and two months of wedded bliss—then another diagnosis, followed by a mastectomy. Bridget and Alex have accepted that cancer treatment is always going to be part of their life, but for the moment, Bridget is cancer-free. And for them, the moment is all that matters.
She doesn’t dream of the Foreign Service anymore; the life she’s fighting for is centered here at home. More than anything, she wants to have children with Alex and be there with him to see them grow up. She thinks about writing a book. She thinks about turning forty. She’s no longer banking on the fairy-tale ending, but she has a great deal of faith that new, better treatments will continue to come along as she needs them. Meanwhile, she helps others cope with the specific challenges of being a young cancer survivor and works for us as a coach, facilitating participants in the Susan G. Komen 3-Day events. Having found her purpose, she’s determined to keep putting one foot in front of the other.
Bridget Mooney Spence was born two months before the very first Race for the Cure event in 1983. When she was in high school, she helped us provide funding for self-exam education, awareness, and the clinical trials that brought monoclonal antibody therapies into common use.
Herceptin was made available to her just in the nick of time. Bridget considers herself incredibly lucky; each setback has occurred in the shadow of a hard-won advance. This remarkable young woman has been literally one step ahead of the disease her entire life.
I am desperate to keep up with her.
T
he morning after my mastectomy, an orderly stopped in to tell me a woman from Reach to Recovery was on her way up to greet me.
“Tell her if she does, I’ll throw her ass out along with the damn falsies.”
I wasn’t in the mood to reach for recovery that day. Nothing against it—it’s been a wonderful program for a lot of years, a trailblazer, God love them. But there’s this idea floating around that people with cancer are obligated to be plucky about it. We’re told to spackle on that positive attitude like television makeup, and here again I had to wonder, for whose benefit would I be doing that? The person who’s patting my hand and telling me not to be upset? Why shouldn’t I be upset? Moments like this are why God
created
upset.
Betty Ford was one of the first people to call me when this snowball started rolling downhill, and she gave me some very good advice.
“Take a day to cry. Get angry. Throw a tantrum. Feel terrible for yourself. Get it all out of your system, then get over it. Get on with it. Get through it.” She mulled that for a moment, then pragmatically added, “You don’t have to do it all in one calendar day. You could do it an hour at a time and spread it out over a few weeks.”
She also warned me about lymphedema in my arm on the side where sentinel nodes (the lymph nodes closest to a malignant tumor) had been removed and talked to me about some of the other strange little nuts and bolts of the situation. Instead of telling me how I should feel, she shared with me what she’d felt, which reassured me that I wasn’t going crazy. There was a strange burning over the front of my body—not the deep agony you’d expect when you’re cringing at the thought of this surgery
and certainly nothing like women must have endured after the old Halsted procedures—but the swarming sensation was insanely unpleasant.