When Breast Cancer Returns
One Patient’s Uplifting StoryBy: Roxanne Jones
“I’m 61, I have metastatic breast cancer, and I’m the happiest I’ve ever been in my life.”
You don’t expect to hear those words from someone in Diana Mehrens’ situation. But they illustrate the equanimity and grace with which she is facing her disease — and her mortality. They also underscore the confidence she has in the care she’s receiving at Eisenhower Lucy Curci Cancer Center.
Mehrens’ cancer journey began in 2002 when, at age 49, she was diagnosed with stage 3 ductal carcinoma of the breast.
“I found the lump during breast self-examination,” she says. “It was a small but very aggressive tumor that had already spread to my lymph nodes. First I had surgery, then entered a clinical trial [headed by the late Eisenhower Oncologist Sebastian George, MD] where I had aggressive chemotherapy, then radiation therapy.”
In addition, because her tumor was estrogen receptor-positive, she started taking an oral medication called an aromatase inhibitor to lower estrogen levels in her body, removing the “fuel” that this type of breast cancer needs to grow.
In January 2003, Mehrens returned to work as a licensed marriage and family therapist at the Barbara Sinatra Children’s Center at Eisenhower, transitioning into private practice in Yucca Valley and doing humanitarian work.
“I was tickled to get back to work; I loved working in my field,” she says. “But I decided to retire in 2008 and focus on the humanitarian work.” Mehrens traveled multiple times to Eastern Europe, visiting children’s homes and teaching mental health professionals how to work with abandoned children.
For 10 years after her cancer treatment, Mehrens saw Eisenhower Medical Oncologist Iliana Popescu, MD, every six months for follow-up to monitor for any signs of a recurrence. Coincidentally, Dr. Popescu’s hometown was one of the Romanian cities where Mehrens had done a lot of humanitarian work.
“Then, in August 2012, my results showed that my tests were abnormal,” Mehrens recalls. “For 10 years, that number had always been where it was supposed to be.”
Subsequent testing revealed that her breast cancer was back and had metastasized (spread) to her spine. The bones are one of the most common sites to which breast cancer metastasizes.
“The PET scan showed that my T-4 vertebra had been eaten away practically to the spinal cord,” Mehrens says.
“I had always known that because of the aggressiveness of my tumor, there was always a chance of it coming back,” she adds.
In fact, Dr. Popescu notes, most cases of this type of breast cancer recur in the first five years, and she credits the aggressive chemotherapy that Mehrens initially received with putting her in remission for 10 years.
“I’ve always believed that that clinical trial probably saved my life, or at least got me to this point,” Mehrens concurs. “Interestingly, within two years of that trial, the chemo I got became standard treatment for my type of breast cancer.”
While metastatic — or stage 4 — breast cancer isn’t curable, it is manageable. Mehrens underwent 25 radiation treatments to destroy the cancer cells in her spine, finishing that course of treatment in November 2012.
Then, Dr. Popescu started Mehrens on a monthly infusion of Zometa, a bone-strengthening medication known as a bisphosphonate. Mehrens also continues to take an aromatase inhibitor to “starve” any breast cancer cells of the estrogen they need to grow.
“Our goal in treating metastatic cancer is to prolong survival, improve symptoms and maintain quality of life,” Dr. Popescu notes. Mehrens’ therapy is having the desired effect. Her most recent PET scan in early January revealed no sign of active cancer in her body.
“I’m in a good place now,” she says. “In the beginning, it was very difficult. I was scared, distraught. I couldn’t ride [my bike] and I was in pain.
“But today I feel really blessed, full of joy and gratitude,” she continues. “I feel fit and healthy, and there a lots of things I can do. I get up every morning and exercise, walking 20 to 22 miles a week, and I have a dog-walking job. I eat well. I’m not around toxic people. I talk to God every day. I read and advocate for other people (Mehrens serves on the Board of breastcancer.org).
“My life is very full,” she adds. “The only time I really think about having cancer is when I’m getting my infusion or seeing the doctor.”
Dr. Popescu lauds Mehrens for being an educated and empowered patient with a positive outlook. “It’s much easier to have patients like her who have educated themselves about their disease,” she says. “They can make rational decisions about their treatment and it’s easier to explain things. I also notice that people who are positive seem to tolerate treatment better.”
Dr. Popescu is positive about the resources Eisenhower offers for people with all stages of breast cancer.
“We have pretty much everything right here at the Lucy Curci Cancer Center, including advanced imaging, cutting-edge radiation therapy and the latest medical treatments available, even if something was approved only a week ago,” she says. “We also offer clinical trials, genetic counseling, nutrition counseling, support groups and exercise classes.
“In the past few years, there are so many new treatments and they’re not necessarily toxic,” Dr. Popescu adds. “And as long as patients keep an open mind…breast cancer used to be life-threatening; now it’s one of the more manageable cancers. There are three million survivors of breast cancer alive today.”
“I’m not afraid of cancer,” Mehrens says. “I understand that it’s just cells that want to live and don’t know they’re bad; they’re just trying to multiply. My perspective on it is, ‘Not in my body!’
“I don’t feel like a victim,” she continues. “I feel very strong in working with this disease and with Dr. Popescu. I totally believe in her and my treatment. You’ve got to have a doctor you can really talk to, trust and believe in — and who listens to you. With Dr. Popescu, I feel well taken care of.
“Every cancer patient is different, but we’re all facing our mortality,” she adds. “If you can embrace it, it sets you free and you’re not so scared. I’m confident I’m going to do well.”