My Breast Cancer Journey, Part I: Discovery, Early Treatment & Healing

March, 2023

First, A Tl;dr:

I was diagnosed with breast cancer three months ago. It’s an ER+ version that had a “micro-metastasis” but is treatable with surgery (done), radiation (underway now) and hormone therapy (coming up). My prognosis is very good.

I’m on a physical (and beyond) healing journey that I feel ready to share for a range of reasons, primarily so others might learn from my experience. Those highlights are towards the end.

Here is my story.

The Call No One Wants

It was December 12, 2022. I was between meetings and hosting a holiday gift wrapping gathering for a few girlfriends, when I got the call. The biopsy of the lump right over my heart in my left breast, came back positive for invasive ductal carcinoma. Breast cancer. Stage 2B.

I was assured that this type of cancer is very treatable with “much better survival odds than even five years ago.” The recommended approach: lumpectomy, possibly followed by chemotherapy, definitely followed by radiation, followed by hormone therapy for five to ten years. “But don’t worry, we have creams for dryness and other side effects,” my doctor said.

December 12, 2022. Home.

Though I don’t have family history of breast or reproductive cancers, I’d had a haunting feeling about my overall health for some time. Even before first discovering this particular lump, I’d been carefully planning a multi-month leave from my role as COO of a multi-billion dollar venture-backed start-up I’d helped build. There were several reasons for this, but a primary one was to “tend to some lurking health concerns.”

In a shameful twist, in addition to the shock I experienced the day I received the call, I also felt a wave of relief. Did I really need a cancer diagnosis to prioritize taking care of myself? Taking meaningful and extended time away from a demanding career for the first time in over twenty years could no longer be framed (by me or others) as weak or a cop-out. It was essential. Whatever it is in me (and countless other women, I’ll note) that felt such a strong sense of duty that I needed a medical emergency to take a break is an area of intense curiosity that I am not taking lightly.

Me?

I was in shock and denial for a day, only telling my beloved partner, Soren. For the next two days, I was overcome by grief. I didn’t like how the treatments sounded. I didn’t want to have what I assumed would be deforming surgery. I didn’t want to endure the intense side effects of the recommended multi-year (estrogen blocking) hormone therapy. The victim orientation felt familiar, reminding me of an old version of myself I thought I’d put to rest years ago.

The woods viewable from our bedroom.

On the fourth day I awoke in our bedroom perched over the redwoods consumed with deep gratitude for the conditions with which I was going to navigate this difficulty. I was alongside my beloved, still asleep. My sons were tucked into their beds down the hall. We had ample savings, a secure and special home, and a community of friends and family who could support us throughout. I have excellent health insurance. We live close to some of the most highly regarded medical facilities in the world. This shift from scared victim to grateful yet admittedly delicate warrior has stayed with me. I am very aware that many women who go through this journey have circumstances far more challenging than mine. This has further humbled and moved me over time.

The rest of December was a blend of navigating a complex maze of scheduling steps, further diagnostic tests, surgeon visits, conversations with friends and family, and trying to get educated, all against the backdrop of the sparkly holiday season. It was also decided at the end of the month that my leave from work would be permanent.

Telling the Kids

Four days after my diagnosis, the kids got out of school for winter break. I’d told my dad by now and he drove me to have an MRI in the morning, while the boys were still in school, to assess whether the cancer had spread. Soren and I then took the boys, five lumbering teen buddies, and our dog Sacha up to the mountains for skiing, poker nights, and plenty of laughs, a trip planned months prior. It felt appropriate to play and be at ease while we waited for more information, before Xander (15) and Tenzin (then 11) knew what I was processing beneath the surface. One morning while they were occupied, I called a doctor-friend to talk through my hesitancy around the hormone therapy. “I used to lose patients to breast cancer all the time, Cecily. I don’t anymore. Yeah, the side effects of these medications aren’t fun, but it’s not cancer.” I’ve replayed this conversation in my mind countless times.

Armed with a positive report from the MRI confirming that there was no visible spread, I was ready to tell the boys when we got home from the mountains. We piled onto Xander’s bed by the window, overlooking the forest, all still in some combination of pajamas and ski clothes in the afternoon sunlight. I was honest: It’s scary. This won’t kill me, but it will change me. Some of the treatments will be difficult. I’m confident that I’ll be fine, but yeah, “it’s going to suck for a while.” As I’m asking friends and family, “please don’t worry, I’ll be okay. Let’s together hold me in a healthy light. Mom is strong, and healthy. We’ve got this.”

A snapshot of the kids and me right after I shared the news. Tenzin said “Mom, you got this! You are big and strong and powerful… and healthy!” We’ve recently added “and loved!” to this family motto.

In recent weeks I’ve maintained a positive outlook with them, but also let them know when I’m struggling. There have been dark and difficult days as well as super bright ones. They know me well and can read my moods easily, so they’ve seen, and we’ve talked through, more of the spectrum of my experience since this first conversation.

Surgery

One month later, after several tests, surgeon meetings, efforts to move treatment forward with urgency despite the holidays… and a fortuitous two day silent meditation retreat the weekend before, I had a lumpectomy at UCSF. My team of nine felt like a band of angels. My surgeon also removed two lymph nodes, what they refer to the “seminal nodes,” or the nodes most likely to contain “escaped” cancer cells if the tumor had metastasized at all. He’d arranged my plan so that a gifted cosmetic surgeon did “the closure.” I wept a week later when the bandages came off. She did such a good job you can barely tell I had surgery. Grateful.

Then, Soren and I, he having been temporarily renamed my Warrior-Angel, waited for the answers to two important questions: (1) Were the margins “clear” (was the entire tumor removed)? and (2) Did the lymph nodes contain cancer (had the cancer spread/metastasized)? They said we’d have the results in five days or so.

Left: Going into surgery. By this point we were confident in our care team, eager to have the cancer removed, and albeit emotional, ready. Bless Soren who encouraged a walk around the parking lot in the sunshine before we went in and was with me every step of the way. Right: From Tenzin. This was in my hand when I went under general anesthesia and still there when I came to in recovery (no doubt in part thanks in part to the physicians and nurses at UCSF who are not only best in class from a medical standpoint, but are also deeply kind, thoughtful, and patient).

That week following surgery was one of the most touching and difficult weeks of my life. Our home filled with handwritten notes, flowers, home-prepared meals, and gift bags spilling over with socks and soaps and teas and candles and clean beauty products and journals and semi-precious stones and books. I felt a love and care from loved ones and friends that held and and allowed me to heal with ease. I took long and slow walks in the woods. I learned to sleep on my back. I missed hot baths (off limits for a month while the incisions healed), but found other ways to relax and stay warm amidst a very cold and wet winter. And I let the love in. Friends, family, moms of the kids’ friends. The kindness and thoughtfulness overwhelmed me at times.

But those days had jagged edges too. As the days went by, four, then five, then a week, then more, I worried that the nodes were not clear, that my cancer had spread. My mind fixated on “If it’s taking this long, it must be bad.” One day in particular I found myself with six hours of idle time and a terrified heart. I wept. I stared out the window. I listened to recordings of Tibetan singing bowls. I napped. I drove over the ridge to Muir Beach and sat in all black in the winter sun, scowling and blinded by the brightness of the world around me. I made a deal with God or the devil, not sure which, that if I was spared metastasis, I would do my part to help raise awareness regarding some of the breast cancer risk factors I’d learned about since starting this journey.

My darkest day. I think I was on this floor for hours. Somehow took a picture (?!)

Sure enough, a few days later than hoped, in a tearful meeting with our oncological surgeon back at the hospital, we learned that one of the two lymph nodes did in fact contain a small bundle of cancer cells, a 1.15mm baby tumor, what is called a “micro-metastasis.”

The facts for those who are curious about these things:

• Tumor size: 2.8 cm
• It is HR+, specifically ER+, PR+, and HER2- with a Ki-67 of 15% (rescored to 5% based on the post-surgery biopsy, a good thing)
• Surgical margins: clear
• Oncotype: 16; Mammaprint negative
• Recommended treatment post surgery: 3 weeks of local radiation + hormone therapy for 5–10 years
• Chemotherapy: optional given a mere 5% likely impact on recurrence

From a sunset drive up to our nearby Mt. Tamalpais with Soren. Perspective helps ❤

I spent the next few weeks continuing to heal from surgery, advancing my understanding of what might have contributed to my cancer (including a deep dive on alcohol as a little-discussed group 1 carcinogen–more on this below), researching various treatment options, spending a week in Baja Mexico attending a workshop Soren co-led with our host Chip Conley on navigating life transitions at the Modern Elder Academy (timely), and spending a beautiful weekend+ with Erica, my closest girlfriend, generously visiting from North Carolina. And everything else. Laundry. Groceries. Making lunches. Dealing with insurance companies. Driving kids around. Life stuff. When my mind went into dark places I phoned a friend or took a walk. Onward.

In my non-doing space, I also continued to tune in and tread the path of the deeper, inner exploration of why this and why now? What is the message? How to I do what I can to prevent this cancer from coming back?

One of the many gardens at Blue Spirit, Nosara, Costa Rica.

For the sixth week of my recovery from surgery, we were able to go on retreat again (all part of the pre-cancer plan for 2023): an Internal Family Systems workshop at Blue Spirit that included a deep detox cleanse, plenty of meditation, time outdoors, deep rest, and powerful time going inward. I also had a most auspicious and transformative connection with Lama Tsultrim, a call to continue to develop my daily meditation practice and inquire about the role of reacquainting with the feminine as part of my journey.

Radiation

Shortly after returning home, it was time to start treatments designed to prevent recurrence. On March 1st, after together with our oncologist deciding to not have chemotherapy given it’s likely low impact on my particular cancer, I started three weeks of radiation therapy. Daily treatments, five days per week, until March 21st.

March 1st, 2023. Each session is about an hour, starting with X-rays to position my heart properly with a repeatable breath hold (with a mask on). Imaging is followed by a set of radiation beams delivered by the robotic module visible at the top of the photo on the left that moves around my body throughout. When I shared concern about the daily chest X-Ray, I was assured that this radiation “is nothing compared to the treatments. Not to worry.”

What is this actually like? First, it’s localized, meaning the radiation beams are delivered via a mobile robotic overhead arm that targets my left breast and armpit area. I’m naked from the waist up, on my back, with my arms over my head. Vulnerable, yet of course trusting the doctors and nurses. I’m usually on the table for an hour, sometimes more. They offered me a blanket the first few days. Now they know I always say yes, so they don’t ask anymore, they simply cover me from the waist down. Sometimes it’s heated, which I love.

In my case, my tumor was immediately over my heart, so I have a somewhat complicated breath hold to draw my heart away from the line of each “beam” of radiation. Sometimes this is easy for me, I’m relaxed and can take the same breath and hold to match the daily X-Ray to position. Sometimes it’s seemingly impossible. My mind wanders to the damage the radiation is causing, it’s proximity to so many sensitive organs, and all of a sudden I’m in a fearful state and can’t get my breath to hold the way I need to. We try again and again. I remember my angels. I remember my practice. I calm my heart. We resume.

One of the toughest parts of radiation therapy for me is what I experience in the waiting room, usually with one or two other patients, also undergoing radiation for cancer. My heart breaks for the tougher journeys, particularly the ladies who are deeply weakened by the intensity and duration of their treatments or the chemotherapy that preceded this part for them. We share deep eye contact, even more potent given our masks, wish each other luck with hands on hearts, and disappear into halls and darkened treatment rooms.

This is a photo of my radiologist’s computer screen, taken on Day Five when he showed me in fantastic detail what is happening and why. This is a 3D rendering of my body. The pink area is where they are targeting the beams.

And side effects? I’d been warned about the intensity and recovery times for surgery, chemotherapy (if needed) and the side effects of the hormone therapy. Everyone seemed to suggest that radiation was fairly straightforward, “you’ll experience some sunburn and fatigue towards the end” I was told.

While I am a robust, bounce-back kinda girl, I’m learning I’m also very sensitive too. This is something relatively new for me. People, places, other sensations and feelings impact me more than they used to (I’m pretty sure this is a good thing). This has meant that I am experiencing the radiation treatments in unusual ways. I can feel the radiation. My dreams are unusually long, vivid, and memorable, for days. I’m also apparently among a small percentage of the population that can actually smell a bi-product of the ionization of the room air, which has been interesting. At least it’s not burning flesh, what I’d assumed before I could ask the doctor(!).

What else? I’m grouchy. More tired in the evenings. Instead of runs, I’m taking walks. I’m also really carefully guarding my early morning quiet time, which I need more than ever. My closest loved ones are just letting me go through it, and supporting in the ways they can. This is an unpleasant chapter, but the end is in sight and though I didn’t think I would, I’m counting the days until my last session.

Next Steps: Hormone Treatment

I meet with my oncologist the week after radiation ends. She is the fourth and hopefully final member of my UCSF Dream Team after the oncological surgeon, the cosmetic surgeon, and the radiologist. It is in that meeting that we’ll confirm a plan to start my go-forward zero-estrogen adventure, basically a combination of oral medications and other treatments to stop estrogen production (ovaries, tissues, all of it). With no estrogen “food” my particular cancer has less of a chance.

Side effects of hormone treatments vary widely and I won’t know much about my experience until we start, but I’ve been encouraged to be prepared for some difficulty adjusting. I do often remind myself that it is these treatments that have both reduced the need for chemotherapy and dramatically improved outcomes for people like me. I’ll continue to tell myself often, at least it’s not cancer.

Big Learnings (So Far): A Triad of Healing

I’ve learned that healing, both in the immediate and longterm, is a non-linear, multi-dimensional experience. This includes new awarenesses regarding body, mind, and spirit/heart — what I’m focusing on in staying cancer free. Here are some of my biggest takeaways so far.

I. Body

One in eight women in the United States will develop breast cancer. There is a lot we can do to protect ourselves from occurrence and recurrence, starting with how we take care of our bodies. Highlights from my research and experience:

1. Take Concerns Seriously. The earlier we can treat breast cancer, the more effective and less invasive the treatment will be. If something doesn’t seem right, don’t delay seeing a doctor. It was foolish of me to not prioritize getting the lump I felt in my breast assessed sooner after I first felt it. I waited the four months until my annual exam which I was told as “as soon as possible.” I’ll never know if that wait materially impacted my long term prognosis.
2. Mammograms Might Not Be Enough. Mammograms are good, but for the countless women like me who have “dense” or “fibrous” (less fatty) breast tissue, tumors are barely visible in these images. If your breasts fall in this category (it will say on your mammogram report) ask for an ultrasound (they’re rarely offered until AFTER a lump is discernible by touch). In my case, my tumor wasn’t visible in my October 2021 nor my November 2022 mammograms, only via ultrasound after I’d felt it. I’m thrilled that the FDA stepped in on this topic in the last week, but please be proactive as these changes trickle through our health care system.
3. Environmental Toxins Really Are A Thing. Without getting obsessed, it has been important for me to get informed about environmental toxins, primarily in our home, and make changes where we can. Cleaning products, cooking tools, scented candles, tap water, cosmetics, and body care products run the gamut of safety. I love this podcast for a great no-nonsense review of what you can do to Cancer-Proof Your Home.
4. Movement. It matters. Running, walking, biking, dance, weights, yoga, whatever your thing is, it’s so important always, but in my case has been essential to stick with it through surgery recovery and radiation treatment. I’ve stayed with a Pilates practice three days per week and get out and run or walk most days. I am certain feeling relatively energized and balanced is tied to this.
5. Nutrition. With support from an oncological nutrition coach, I’m on a pure, organic, plant-based diet right now through treatment. It’s easier to list what I do eat rather than my lengthy list of nos: vegetables (at least ten different ones a day), legumes, fish (not a lot), eggs (on occasion), seeds, nuts, and very little fruit. I start each day with a minimum 12-ingredient smoothie, drink tons of water and green tea, and still enjoy coffee. I wish I was more aware of sugar intake before this experience. It’s everywhere… in kale chips, granola, salad dressing, hummus, salsa, bags of nuts, and more. I’ll share a lot more about nutrition in future posts. It fascinates me.
6. Alcohol. Alcohol is a group 1 carcinogen alongside tobacco, asbestos, and benzene and has been scientifically linked to seven cancers (including breast). I’ve been alcohol free for more than five years (you can read a bit about my ClearLife experience here and here). None of my reasons for this choice included avoiding cancer (like quitting cigarettes did decades ago), so I was pretty alarmed to discover this. I am collecting research here (NYT, NIH, Wired, American Cancer Society, WHO, and countless others referenced). More to come.

II. Mind

A cancer diagnosis can be terrifying. Part of my journey has been doing what I can to stay clear, calm and sensibly positive. I’ve learned that features of the mind before and beyond these months are extremely important to ensuring I am well positioned to thrive well beyond this chapter.

This altar of sorts has organically assembled in recent months. It’s where I start each day with a bit of practice and precious quiet. Items were gifted by friends, family, and my shaman-sisters :)

1. Stress. Stress is linked to cancer. I suspect that years of chronic stress, primarily managing feeling torn between motherhood and my profession (always feeling like I should be somewhere else, more on this below) took its toll. I’m currently deeply attuned to what triggers a stress response, navigating accordingly, and staying curious.
2. Mindset. Mindset matters. Our friend Joanie was so clear and kind with me in talking me through how to orient with cancer treatments when we sat the January retreat together. She sees treatments, even the difficult and “toxic” versions, as healing options to be deeply grateful for, not fear or resent. For example, she referred to her chemotherapy as nectar (her incredible story is here). I can feel that days I start with a positive mindset proceed far better than the others and believe that this overall orientation supports efficacy as well.
3. Meditation. Anyone with a regular practice does not need science to confirm its benefits, but for those who like research, here you go. Meditation has proven to be beneficial “in various aspects of cancer management” asserts the NIH. It is amazing what we can take on with a calm heart. Luckily I was well on my way here when I started this journey, but it has become even more important than ever.

Spirit / Heart

This part of my healing journey is unfolding realtime, daily. So this is probably the material for an even more intimate, dedicated share down the road, but here is where I am so far.

Some of the delicate light, love, and life in our home in recent weeks.

1. Feeling Torn. I have a longstanding tendency to get caught between various identities and obligatory commitments, losing touch with myself. This shows up as inauthenticity, lack of presence, and misalignment. It’s been a thing for most of my life and I’m working hard to change course. I’ve often felt torn between roles, primarily that of mother and executive. I spent years feeling guilt, shame, and frustration for being somewhere when I thought I should be somewhere else — on a luxury business trip feeling terrible about missing an event with one of my sons, or doing something with my kids and feeling ashamed for not attending a particular meeting. I experienced something similar in trying to support my ill mother for decades: Do I show up for her in a loving, caring, truthfully enabling way or do I play hardball and cut her off until she is willing to get help? What this is really about at its core is honoring ourselves. Listening to intuition. Having the courage to commit to one thing over another. Annihilating shoulds. This exploration includes intentional reminders to not get stuck in shame too, have compassion for myself, others.
2. The Power of the Feminine. It is no coincidence that my tumor was an estrogen-positive (fed by estrogen) cancer that grew immediately over my heart. I’ve been working incredibly hard to “succeed” in a mans’ world for decades. As a result, my own innate feminine energy, my sensuality, my deeper more intuitive and creative ways had little expression outside of carefully defined boundaries (typically in the bedroom with a monogamous male partner). With all of that repressed feminine energy, it is no surprise that I developed a tumor that would thrive on estrogen as its food. I’m working to cultivate, honor, and express that femininity and sensuality in new ways, expanding boundaries. I’m now on an irreversible course that I’ll share more about as this evolves.
3. Five Questions. I recently met Dr. Neha Sangwan and shared some of my journey with her. She asked five brilliant questions from her book, TalkRx: (1) “Why this?” (2) “Why now?” (3) “What signals might I have missed?” (4) “What else in my life needs to be healed?” (5) “If I spoke from the heart, what would I say?” I’ll save the details on my answers for another time, but I will note that the answer to the last question came immediately: “Thank you.” Life will never be the same, and in most ways, I am grateful for that.

Today was “Radiation Hump Day.” Eight treatments down, seven to go. I stayed in bed a bit longer, appreciating the warmth of Soren alongside me and the sound of the rain in the woods around us. I watched a bit of comedy TikTok with Xander before school. I noticed moss on rocks next to our garden steps walking up to my car. Tenzin and I didn’t rush home from pick-up, but instead went to the local market to get fruit smoothie ingredients for him–even danced a bit in the parking lot …and we’re all saying “I love you” a lot more.

Thank you for reading.

Onward ❤