Living with Advanced Breast Cancer
A Life Changing Journey by Karen Hirsh

As a three time breast cancer survivor, I will tell you this disease has dramatically changed my life. I do not know why I have cancer, but I do know that I am blessed with a new perspective on life.

Before cancer, I was always the one in control, juggling everything to care for my family and manage my career. Now, I have learned that life is not always wrapped up in a neat little box, that I must adapt and cope with each new situation. I have also come to realize that I can control the decisions I make and how I approach living with a life-threatening disease. My hope is that by sharing my experience I can help others understand that while this disease dramatically impacts one's life, it does not mean that a person cannot aspire, achieve and transcend expectations.

My first diagnosis came when I was in my mid-30's. A biopsy indicated DCIS (ductal carcinoma in situ), a pre-cancerous diagnosis in the milk ducts. I had a lumpectomy, radiation and hormonal therapy. When it was all over, I went back to my life.

Two years later, following my mammography, the report came back that there were multiple spots on the same breast. I had Stage 1 invasive breast cancer. Following a mastectomy of the right breast, I underwent more than 12 hours of reconstructive surgery. I left the hospital determined to quickly resume a normal life. I began my own physical therapy regimen and returned to work in two weeks. Then I learned I needed chemotherapy. Breast cancer started to really change my life.

For me, one of the most difficult adjustments was to wear a wig. Two of my friends spent hours helping me pick the perfect wig. At first, I wore it over my own hair. A neighbor saw me and asked my secret to keeping my hair looking so great. I hope one day I can find the words to thank her for what she unknowingly did for me. Once my hair began to fall out, I cut it off, and the wig became part of the "new me." Cutting my own hair represented control; at least if my hair was going to leave it was by my own hand. Chemotherapy was tough, and I struggled through feeling sick and unhealthy, but with resolve, and I never missed a day of work or exercise. Again, I healed and put the experience behind me as another blip on life's radar screen. Surely I would not be tested again… I thought.

Another two years went by; my breast cancer tumor markers were elevated. I repeated the blood test quickly. You see, with a cancer diagnosis there is no time: you listen, you trust and you take action. I had metastatic disease in my liver and the soft tissue in my pelvis; I had Stage IV breast cancer. I was in my early 40's and cancer was back again for the third time! It was relentless. It took hold of me and did not want to leave. My body became its home and my life would be forever changed in ways that were truly remarkable.

One of my first priorities became to find an oncologist that would be a partner in my care. During my search I was told everything from "You will die within a year" to "I will let you know when you are declining." I was outraged! Surely people can live with this disease and there was a physician who believed and could offer hope. The pieces slowly started to come together for me. Finally I met a wonderful oncologist that thinks "out of the box" and educates me on an integrative approach to healing and wellness through drug therapy, diet, nutritional supplements, and daily exercise. Working with him I mobilized a support team. Each has brought me different gifts, encouraging me to stay strong and providing me with support and an anchor.

One of the many miracles I encountered during this time was meeting cancer survivors who are now cancer free. They showed me that anything was possible and to never give up. I also read stories of survival and people who defied odds. I began to believe there were forces far beyond our comprehension and that I had the power to help heal myself. I became a voracious reader of survivorship and leadership to better understand what characterizes a person who has survived against great odds. I came to believe what differentiates these people from others is how they use their minds to maintain focus, thinking creatively and leveraging all opportunities to achieve their goals. They maintain optimism, never give up and embrace what life brings to them. Staying in the present, with an eye on the future, and maintaining calm balance, I find, is essential to the management of a life threatening disease.

Shortly after my third diagnosis, I spoke at a local Cancer Black Tie event about cancer in the workplace. I urged all the corporate leaders present to appreciate the challenges of a cancer diagnosis among their employees, but also to trust that people can live with this disease and still be high producers in their organizations. Today cancer is a chronic disease, I told them, and people live and work with it every day.

Unfortunately, there is a stigma associated with having cancer. I have experienced it
from colleagues, acquaintances and medical professionals. My Stage IV diagnosis has
meant missed days from work because of medical appointments. I receive weekly chemotherapy treatments, and the time I need to devote to my health is a top priority. My professional life is very important to me, and often I must deal with those who do not recognize that even with this disease, I am a top performer at the workplace, but just need a somewhat flexible work arrangement. It is misguided to equate work excellence with a traditional 9:00 to 5:00 work model. The stigma can only be broken down through increased education, personal action and helping others understand that living with cancer is possible.

It is only recently that I can speak openly about my disease. I had always been a proud person and private about my illness, scared to talk about it openly for fear of being looked at differently or pitied. I had deluded myself to believe I had hidden it. I just wanted to be "Karen," not "Karen who has breast cancer." Today I continue to work full time and am an ardent advocate for breast cancer and rights at the workplace.

Exercise has become central to my life and brings me inner peace and strength, both physically and emotionally. It shows me that because I have an illness does not mean I am different or limited. Every time I exercise and push my body physically, I feel a tremendous sense of accomplishment and purpose. As long as I can exercise, work and care for my family, I am very much alive.

It has been eight years since my first diagnosis and three and a half years post my Stage IV diagnosis. Throughout my journey there has been tremendous change, barrier management and growth. I have learned that I have choices about how I want cancer to impact my life. My disease is my disease; it is being managed and although part of my life, it does not define my life. I have also learned not to listen to dire predictions and not to pay attention to statistics. I am not a population pool, but an individual, and my story is my own. I have come to embrace my new life and know that I have so much more that I plan on achieving. I have also come to know and rely on my inner self and trust it will help guide and care for me. The possibilities are endless!

Editor's Note: Karen lost her battle with cancer on June 7, 2010. We are deeply saddened by her passing. She remains an inspiration to all women.