Intro: Welcome to Conversations on Cancer, brought to you by the Riverside Cancer Institute, providing answers, debunking myths, and sharing patient stories.

Dr. Ahsan Basha (Host): Hello. This is Dr. Ahsan Basha, coming to you again from our podcast, The C Word: Community, Not Cancer. Today, we have a guest, Anna. Welcome to our podcast. Anna had been under the care of Dr. Lacher, who's in our group, for the management of breast cancer. So, Anna, tell me how this all started for you initially.

Anna: It started, I went for my regular annual checkup with Dr. Goldklang, and she recommended I get a mammogram. So, I went and got that, and I was told that I needed to come and get more imaging because they've seen something on there. And so, I did, and then I got the phone call, "You have cancer." Thank goodness, the young lady who told me this, Holly, at Dr.  Goldklang's office, she was very, very sweet because she said she knew this Thursday night, but she said, "I wanted you to get a good night's sleep before I told you." So, she called me Friday morning, and told me. And I very much appreciated that.

Host: Yeah.

Anna: Because I would have not slept all night.

Host: Got it. Got it. How did that news impact you Friday morning?

Anna: Huge. It impacted me huge. I was kind of, like, in shock because I honestly didn't know where to start. It's like, "Okay, what do I do with this?" It's like this new reality. And it's like I had no idea where to even begin. But I looked at the report and, at the end of the report, from the doctor, it said that I needed to seek surgical and oncology. So, I thought, "Okay, I need to find an oncologist. I need to find a surgeon and figure out what my plan is."

Host: Where you're going. Yeah.

Anna: So, the next thing I did, because I knew absolutely no one with breast cancer—no one, in my 64 years or whatever. And I'm like, "Where do I begin with this? Who do I talk to?" So, I went to work the next day, and I was telling the other employees. And one of the ladies goes, "Oh, I know someone." She goes, "Let me make a phone call and see if I can get you connected." And she did. That was a lifesaver, because I also knew this person. I didn't know her personally, but I knew of her. Our sons were in Scouts together, and I said, "Yes, I want to talk to her."

Well, she told me that she had her treatment done at Northwestern. And she had her cancer treatment itself done at Riverside Cancer Institute. And I said, "Okay, this is good." And she also had plastic surgery at Northwestern. Well, I wanted to have plastic surgery. So, I knew then by speaking with her that I needed a surgeon and a plastic surgeon that worked together. That was most important to me.

So, I made appointments. I made appointment with Dr. Bethke and Dr. Neil Fine up at Northwestern. They got me in. I was diagnosed in February. They got me in in March. And I made an appointment with Dr.  Lacher, my oncologist. So, I thought, "Okay, let's go from here and see what happens." So, my husband and I went to Northwestern. And we've probably seen more of Chicago than we probably ever would have.

But it was good. It was really good. I very much felt at ease after talking with Dr. Bethke and Dr. Fine. They talked about the approach, what they were going to do, how they were going to do it. I had first though, before I went to them, I went to Dr. Lane here in Bourbonnais. I respect him very much. And I wanted to get his opinion before I went elsewhere. And he said, I remember him coming in and telling me that he could do no less than a mastectomy, and I just remember the tears.

So, okay, after I got through with that, I made the appointment with Dr. Bethke, and I went to see him. And by then, I was like, "Okay, this is the new reality." And I talked to him and I told him, "Okay, if I'm going to do this, I want to do both sides." Because my right side had cancer. My left side was the side that gave me issues. I already had two surgeries on the other side. I'd already had numerous biopsies on the other side. I'm like, "Why is it the right side? It never gave me any problems."

So, the insurance and Dr. Bethke both approved that, because it had so many issues on the left side. They said, "We need to do them both." So, it was decided that I would go have the chemo first. Six treatments of chemo before I would have the surgery.

Host: If I can just put a quick pause on that. So, I just explained to the people listening, reviewing Anna's history in the chart, I had noticed that, yes, you had multiple biopsies in the left breast, and that was the area of concern the whole time. And all the biopsies had been negative for cancer. But in the screening mammogram that you end up having, it turned out the cancer in the right breast. So, I had noticed that. And I appreciate you explaining how you got to Dr. Bethke because the chart did tell me you went to see the doctor. It didn't tell me all the—

Anna: The ins and outs?

Host: Not the ins and out, the anguish, I guess, in a way. The anguish that got you there and got you hooked up with him. And that's something you can't pick up from a chart just reading it. That's why we do this, is to say, "Okay, how did this person get into this."

Anna: And I think that's the most difficult part. You know, this is where I say, "Okay, God came in." Because when I went into work that day, I still did not know what I was going to do, did not know how I was going to approach this. I felt it was a God moment, because just opening my mouth, a person who is only there once a week that I was working with was the one who put me in the direction that I needed to go. And that one person was there. That one person made the contact that I needed. And that opened the doors for me and made me feel, "Oh my gosh, I actually feel in control." And that's the kind of person I am. I want to be in control. And no matter what, I don't want somebody else doing it for me. So, that made me very, very happy. I'm like, "Okay, we're going to do this."

Host: If I could ask, how did you get to Dr. Lacher?

Anna: Somebody had recommended a different doctor—

Host: Yeah.

Anna: Yeah. And so, when I came here, that's who this lady had. I'm not going to mention names because it's personal.

Host: Sure.

Anna: Anyway, that's who she had, and she said at the Riverside Cancer. And I said, "Okay." So, I came in on her recommendation, but they said she was leaving. And they said that they highly recommended Dr.  Lacher. I did not know her. But I was very blessed to get her. She was wonderful. Absolutely wonderful.

Host: Can you tell me how that first meeting went for you?

Anna: It went great. It went real good.

Host: How did she put you at ease? Or how did you decide you felt comfortable?

Anna: She just had a very open personality. Very sweet, very kind. And I felt like she understood me. I liked everything she said about the treatment, the approach. I felt comfortable.

Host: Good. So, I'm just going to summarize again for our listening audience. So, after Anna met with Dr. Lacher and with Dr. Bethke, they decided on what's called a neoadjuvant approach, meaning doing chemotherapy before surgery. And Anna's breast cancer had specific characteristics, meaning there was what's called estrogen receptor positive, meaning it was sensitive to hormones. But it also had a protein called HER2/neu.

HER2/neu can make breast cancers more aggressive and less sensitive to chemotherapy. But it also, in a very positive way, acts as a target that doctors like Dr. Lacher and myself can target as a way of attacking the cancer, both before and after surgery. So back before we had any treatments, it was a bad thing. But now, we consider it almost a positive thing as something we can target.

So, Anna did undergo this neoadjuvant chemotherapy. You said six cycles of the chemotherapy. How did that go for you?

Anna: Not so good at first. I was told that I had to drink a lot, a lot of water. I mean, a lot of water. I couldn't do it. As hard as I tried, I couldn't do it. And I had my first chemo. And then, I had it on a Thursday, and then the weekend came and I just felt really weak. Then, I went to work on Monday. And I did not think I would make it through the afternoon. And I came here, and I remember walking in the door and the nurse said, "You need fluids." And I was like, "Oh, bless her heart." And I felt so much better. And so, from then on, I would have my treatment on Thursday, and I had fluids on Friday. And that is what I needed to get me through.

Host: Yeah. So, they found a way to work for you. And it worked for you.

Anna: It worked wonderful. It made me very weak, but I made sure that I moved. I walked and walked. I'd be lucky if I could get to the corner and back, But I did it. And I had so much support, so many people, "Oh, I'll walk with you," you know? I had a a sister-in-law who lived down the street who was always walking with me, because I thought, "Okay, if I fall, am I going to get back up? I got to find a tree to climb up." But the fifth one, I thought I would never get to the sixth one. Because the fifth one just left me so drained. But Dr. Lacher said, "Let's give you a week. We're going to give you another week," and it worked. And I got the sixth one, and it was good.

Host: You made it through. Right.

Anna: I made it.

Host: And then, Anna did go to surgery with Dr. Bethke. And the surgery was, from what I read, very successful. They did find little small amounts of breast cancer remaining in the breast after they did surgery. There's nothing left in the body that they could identify, but the margins were all negative. But within the breast itself, there was still a little bit of residual cancer in there. So then, Dr. Lacher recommended some treatment afterwards.

Anna: Yes. I had 14 immunity infusions.

Host: Yeah. So, she received, to be honest, what's a relatively new treatment, a drug called Enhertu. So, it targets these HER2-positive proteins again in a different way, and has added amazing results, to be honest, from an oncologist point of view. And it's something if you'd come a few years earlier, we wouldn't have not had that. So, it was kind of beneficial in terms of timing in that you were able to receive this Enhertu, which they used for a year as a form of maintenance therapy and cleanup kind of thing. And so, any issues with receiving that drug?

Anna: No. I was good that.

Host: Okay. And so, you finished your last treatment March of last year, is that correct, or two years ago?

Anna: In '24.

Host: March of '24. So, you completed that, and you've been free of any IV drugs since then—

Anna: No, I think it was August. It might have been August.

Host: Okay. You got 14 treatments.

Anna: Yeah, somewhere in there.

Host: You got 14 treatments. And in '24, you finished. And now, she remains on an endocrine pill called letrozole, I believe.

Anna: Yes.

Host: Okay. Which you're taking as a way of, again, ensuring we lower the risk of cancer coming back. It's a pill. So, that's kind of the nuts and bolts of how you got through everything.

Anna: Yeah.

Host: Now, I want to hear—you kind of hinted at it with your sister who walked with you.

Anna: My sister-in-law.

Host: Sister-in-law?

Anna: Yeah. She would walk—

Host: So, tell me about your support system as you kind of went through all of this.

Anna: Oh my gosh. My work, the people I worked with were absolutely wonderful. My work itself was very, very flexible. That helped me tremendously. If I couldn't get through the day, go home. I was able to work my job around the hours here. I had a flexible job, which helped very much. So, there wasn't a lot of interference. But it was very workable. The support system from my family, my children were absolutely wonderful. Absolutely wonderful. My family, my husband, he made so many trips to Chicago—and on the train too—driving. So many trips, but he did it. And we did it together.

And I still remember after seeing Dr. Bethke and Dr. Fine. We're sitting at a restaurant in Chicago, just looking out and thinking, "Oh my gosh, we just did this." And it was just so much, but we did it. But my family was just very, very wonderful. Also, my daughter-in-law would bring my two little grandsons. At the time, they were three and six. They lived not far from the cancer center. So when they were riding their bikes or walking the dog, my daughter-in-law would bring the little boys to see me through the window. And they were so excited on the day that they got to see Grandma get her treatment. And that made my day, because I knew when I walked in the cancer center, I knew I was going to see my grandsons.

And besides, this cancer center has a huge, wonderful team. It's so wonderful from the minute you walk in to the minute you leave. I can't even name one of them, because they're all so wonderful. So, I'd be sitting there getting my treatment and my grandsons be looking at me. And they'd have their nose up to the window. And I just thank God for those long windows because—

Host: Yes.

Anna: Because there they are. "It's grandma." And my gosh. It just made me cry every time.

Host: Oh, that's great. That, again, is a comment—we moved to this building almost 10 years ago, I think. Before we used to be on the third floor or actually sixth floor of the professional building across from the hospital. But now, we have a campus where we have these big huge windows looking out onto a pond/lake behind us, and a little walkway there. And I guess that's where your grandsons—that's where they walk around.

Anna: That's where they walk around. And then they go see grandma. And the cutest part is April, in just April, my daughter-in-law sent me a picture of my grandson looking through the window. She says, "He still thinks that there. He's still looking for you every time we go for a walk."

Host: That's so funny.

Anna: And oh my gosh. I just loved it. And that's been two years ago. And he still thinks of me, that he remembers that.

Host: What memories stand out to you in terms of—I mean, you said you had adult support, but what are the biggest memories going through this whole experience?

Anna: I think the support from my family. My daughter, I mean, she spoiled me. There was care packages all the time from my family. I think people who I wouldn't even have imagined reached out to me. And I'm like thinking, "Wow." I think it came because it was so unexpected. I didn't expect such a huge support system from everyone, family, friends. It was huge, and it got me through it.

Host: That's great. That's wonderful.

Anna: My sister would come here to visit. My other sister-in-law—I could go on and name every single person. But all of them were wonderful. But the people here at Riverside, they made that possible because such good attitudes. You could tell they enjoyed what they did. They loved what they did. When you walked in the doors, it wasn't like, "Oh my gosh, I'm here for this." It wasn't like doomsday. It was bright. People were cheery. You know, "Oh, you want some treats?" You know, it wasn't depressing. And I think that's what made it easy to come back. It made it easy to get through, because of such nice people.

Host: As someone who's worked here for 15 years, I would agree with you, Anna. I love the people who work here. I love all the stuff they do, and they do care for every single patient who comes through and wants to get them through as optimistically and helpful as possible.

I guess one of the things I can just ask you, I guess, in a way—I I think I have the answer—is you could have done your chemotherapy up at Northwestern, what was it like being able to be here where your grandkids could come?

Anna: Wonderful. Oh, this was huge. Having this here, oh my gosh, was huge. It would've been very trying, very hard, very difficult if I had to do this all at Northwestern. This was really, as far as my health was concerned, this was a better option, because you're exhausted.

Host: We are very blessed that we can be here for you and the community that, so you can be close by and you can have the family right here. And we actually have four campuses, so we try to be as close as possible to people we're taking care of. And so, that's wonderful to hear you say. I love the story about your grandkids being able to visit. I think that's just an amazing story to hear.

So if you had to give advice to somebody who's just starting their cancer journey, what would that advice be from you?

Anna: Talk to as many people as you can until you get answers. Because I knew no one who had breast cancer when I was diagnosed. And I really felt very, very much alone. But just opening up and putting it out there, that gave me answers. It gave me what I needed. It gave me connections that I did not have. So, speak up. Talk to people. And review all your options.

Host: You know, listening again, you don't get all this information just reading papers on the chart. So, I love the story that you're telling me.

So, you look great, Anna.

Anna: Thank you.

Host: I'm glad you got through all this the way you've gotten through it. And I'm glad you're able to tell your story and that you can provide this experience for our listeners to get help when they hopefully don't have to go through it, but if they do, you know, they have a story to listen to.

 Well, thank you again, Anna. I appreciate you sharing your story and your experience with us and to the community. Thanks again for listening to The C Word: Community, Not Cancer.