Breast cancer has been on the rise for years—but over the last decade we’ve seen a startling 8 percent increase in women under 40. And up to about 55 percent of them have had a child within the last five to 10 years prior to their diagnosis—with the highest risk in women who had their first child after the age of 30. Meanwhile the growing trend of women delaying pregnancy is estimated to be a contributing factor for the global increase in breast cancer incidence.
This year, two famous moms in their early 40s—Olivia Munn (43 years old) and Kate Middleton (42 years old)—announced their cancer diagnosis. Navigating cancer is challenging but adding motherhood to the mix is a whole different ball game.
We know more women are having children later in life for a multitude of reasons.
I was one of them. I had my first child at the age of 32, and received my breast cancer diagnosis at the age of 36, four years after having my son.
I’m an example of these very statistics, and while I wouldn’t change a thing in my journey to becoming a mother, I consider myself lucky.
Since I work at the Breast Cancer Research Foundation (BCRF), I had (and continue to have) a unique awareness of my risk factor. When I found a suspicious lump, I didn’t ignore it. In fact, I kept track of it for a month to see if it would change with hormonal fluctuations. When it didn’t, I immediately sought a doctor.
I knew that it could be nothing, but since I was still within the 10-year window of elevated risk, it could be something.
Nonetheless I was shocked when the doctor confirmed my suspicions: that the lump in my breast—and the one I didn’t know I had in my underarm—were in fact cancerous.
I was diagnosed with hormone-receptor positive, HER2-negative breast cancer that had spread to my lymph nodes.
This meant that my treatment plan included four months of chemotherapy, a bi-lateral mastectomy, five weeks of daily radiation and then, six months later, a DIEP flap reconstructive surgery (which means I used my own abdominal tissue to recreate breasts).
Yes—this was indeed as intense, frightening, and unrelenting as it sounds.
But thankfully, my years at BCRF prepared me to understand the language my doctors were batting around. I didn’t have to Google anything. I knew exactly what to ask. And the only way to quiet the deafening alarm bells in my head was by reminding myself of the science—the science fueled by my work. I knew that there were targeted treatments available for my specific subtype of cancer.
And yet, during all of this, I was still a mom. A mom doing all of the mom stuff—from the visible to the invisible load of parenting and running a household.
I had to unpack our things in our new house while my son started pre-K at a new school. I had to think about what we were serving for dinner and if the fridge was full. I had to think about homework, playdates, laundry. All of it, on top of also, working.
Knowing I needed a village more than ever, I tried making new mom-friends while navigating treatment. I was attempting to make friendly small talk with neighbors and parents while wondering: “Can they tell I’m bald under this hat? Do they think my eyebrows look drawn? Do I tell them I have cancer now?”
And not to mention, when I finally did drop the C-bomb, reactions varied. Some people were great, and others just got awkward. The news often made it difficult to bond over the weighty issue of choosing a birthday party theme (superheroes or Blippi) when I was preoccupied with losing my nipples.
How do you tell your toddler you have cancer?
How do you explain the complexities of a cancer diagnosis to a child? Sharing the news with my husband, son, and parents was the hardest part of the experience. These are the people that normally lean on me for support and love me more than anyone else in the world.
When I shared the news with my son, who was four years old at the time, I was nervous. More than fear or sadness, I was anxious about messing it up, saying the wrong thing and traumatizing him. So the best way for me to manage that was to do as much research as I could before telling him.
I learned some key tips, but overall I tried to do a few things: to be clear and honest, but gentle and reassuring. I talked to him in terms that he could understand and relate to. I used the word cancer, which was harder for me than it was for him and made sure he knew it wasn’t contagious.
We talked about how I had cells inside my body and one of the cells malfunctioned and needed fixing. When I explained that the medicine and doctors were superheroes, everything else was easy for him to understand. For example, when it came to chemo and losing my hair, I explained that my hair contained special powers that helped the medicine get “supercharged” to defeat any bad, malfunctioning cells. When I was too tired to play, it’s because the medicine was hard at work getting the bad guys.
Of course, routine and constancy were also very important. All my son ever asked of me was to read stories at bedtime. And if I could do that, he could deal with everything else.
Through it all, he was amazingly understanding. Young kids have a remarkable capacity for resilience.
The one thing I wanted to maintain was the parent-child dynamic. When that role is reversed and parentification occurs—that is, the child takes on a disproportionate burden of parental responsibilities, the risk for longer-term trauma holds the highest potential.
Wherever possible, lean on your spouse or family and friends to take on any excess responsibilities you can no longer fulfill. I used every moment of my “good days” to be present and involved. Diving back into the daily chores of parenting, chaperoning field trips, joining birthday parties or activities, made me feel whole again.
It relieved some of the constant guilt at not being available when I was feeling unwell. So in many ways, it was just as much for me as it was for him.
Creating my village
The biggest challenge of all is asking for help when you can. As moms, we are trained to be the helper, not to need the helping. But I found that when I finally needed help, my husband stepped up to the plate and the silver lining has been the fact that I was forced to stop micromanaging him, allowing him to take on more responsibilities at home.
Furthermore, a diagnosis can trigger an outpouring of love from family and friends. Savor that! It’s precious. But often they ask, “Let me know what I can do to help.”
While it isn’t terribly helpful to have the added homework of delegating tasks, taking the time to build your team sets you up for the marathon of treatment.
That includes selecting a couple of close friends who can be in charge of delegating responsibilities to others, letting someone be in charge of updating the friend group so you don’t have to repeat the same story, and setting up “meal trains” so that your partner/spouse is unburdened of the responsibility of cooking dinner.
This also includes looping in your kids’ teachers. Teachers can provide added support during the school day when they know what is happening at home. Provide them with the language you’ve been using at home and keep them updated on what is going on.
Accepting my new reality
When I was diagnosed with cancer, my husband and I were trying to build our family and have a second child. My oncologist encouraged me to consider doing an egg extraction to create embryos as an insurance policy before beginning chemotherapy (which can be brutal on your reproductive system).
When cancer patients choose to delay their treatment for weeks and weeks, it takes a special kind of bravery and unexplainable depth of desire to feel like you’re risking your life for just a chance at motherhood or—like in my case—to give your child a sibling and to complete the family you had dreamed of.
Anyone who has remotely struggled with infertility is familiar with that uniquely desperate feeling. And in my case, I wasn’t brave enough.
When you’re diagnosed it feels like your house is on fire and someone is asking if you’d like to wait a few weeks to put it out—even though I had the most reassuring doctor telling me it was perfectly safe. I just couldn’t wait. I didn’t trust my body to keep me safe. And it was gut wrenching to give up that insurance policy for having another baby.
It is still the deepest, most bloody cut. For young patients, studies have shown that infertility is the biggest fear of cancer, second only to recurrence. If this is you, know that you’re not alone and that there are more options now for fertility after treatment than ever before.
I still find myself struggling to readjust my vision of the future. I try to redirect the love and energy I have towards my nieces and nephews in hopes that they can fill the hole left in my heart, the extra space I had in there for the dream of my second.
What’s next for me
From the moment of diagnosis, patients cross over into “survivorship.” While in active treatment—some combination of chemo, surgery, and radiation—patients often find themselves in constant motion. Too busy to deal with the emotional consequences of a diagnosis.
Once the dust settled, I finally had a chance to process what I’d just endured.
Survivorship sounds like such an uplifting word. It belies the complexity it holds: encapsulating the emotional toll of sorting through the vestiges of your old life, while also finding your footing in your new body, your new life, your new perspective.
The changes are so vast and so fast that it can be even more challenging than the period of being in active treatment. I find myself in this stage now: Where I am so grateful to be done with treatment, but too terrified to declare myself “cancer free” or even use the word “survivor.”
I live in constant fear of any new pain, ache or bump. It took me some time to finally seek the help of a therapist and anxiety medications.
For many patients—too many patients—they may even find themselves in some form of treatment for the rest of their lives.
Even now as I continue to diligently take the medications that I’ll be on for the next five years and manage the staggering side effects of being in forced menopause, I find myself continuing to discover new parts of myself. I continue to find solace in science—in every new study our scientists unveil and have tremendous hope for the future.
This entire experience has taught me that being a mom can really set you up to deal with anything because you have no choice: You have to be ok for them. Somehow, pretending to be ok for my son, helped trick me into believing it too.
