What Makes a Cancer Survivor, Anyway?

They say you become a cancer survivor from the moment you are diagnosed, for as long as you are alive. If that's the case, later this summer will mark 8 years since I became a breast cancer survivor. Eight years and I still grapple with the term survivor, like I should be on a deserted island competing for a million dollars. Although I guess there are parallels between the long-running reality t.v. show and cancer, like facing unfamiliar challenges that have the potential to kill you. Learning to navigate one's way from an infusion chair to the bathroom while connected by three different tubes to a chemo pole is not the same as learning to fish for your dinner with a spear, though. I don't think.

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I never asked “Why me?” when I was diagnosed with cancer. I knew it was too random for there to be any explanation from the universe that made more sense than that. But every day since I stopped being a terminal patient and moved to the realm of people who can look at cancer in the rear view mirror, I have wondered why. Why did I survive? . . . I’m not sure I’ll ever know the full answer to that, but as one of my favorite survivors said this morning, “I want to help other cancer patients know what the other side can look like.” That, and I want others to know what questions they might ask to avoid a story quite like mine. . . . For me, surviving cancer means falling in love with myself again. It means forgiving my imperfections because they are my story. It means the possibility another life unfolding before me, my toddler chasing our dog down the hallway and around the coffee table while squealing with glee, fearless. She is teaching me to be brave again. It means I get to imagine a future. This is what it could be like. #nationalcancersurvivorsday #breastcancer #bcsm #cancersurvivor

A post shared by Jen Campisano (@jencampisano) on Jun 2, 2019 at 4:48pm PDT

Lots of patients instead mark survivorship from the day they finish treatments. By that definition, I've been surviving cancer for just over 3 years. But that definition doesn't sit well with me, as it leaves out too many who never get to finish treatment. For five years, I thought I would be one of those patients who died with my disease. Was I not surviving then? In some ways, it felt like I was hyper-alive -- surviving in a vivid, punchy, super-saturated way -- during that period. As my friend Emily wrote about living with metastatic breast cancer a few days ago:

I feel like I have been moving at such a frenetic pace lately because I am continually reminded that my timeline has been drastically shortened. How do you fit an entire career, and an entire lifetime, into the space of “months to years”? You can’t. And you don’t. No matter how hard you try.

But oh how we try. Nothing like coming face-to-face with your mortality -- and a generous dose of treatment-based steroids, too -- to shock your system and routines into high gear for a bit.

And plenty of patients, mostly those I know in the metastatic community, but not exclusively, shun the term 'survivor' altogether. For them, it feels wrong to leave out those who didn't make it. The word feels too exclusive and divisive -- and celebratory, even, in the face of what is often a cruel and devastating disease. I totally respect that line of thinking.

On the other hand, I also think this life is worth celebrating, even in the midst of a terrifying shit-storm. As my late friend Lisa Bonchek Adams said so wonderfully when she was facing the end of her life:

“Find a bit of beauty in the world. Share it. If you can’t find it, create it. Some days this may be hard to do. Persevere.” 

My bit of beauty in this world

Sunday was National Cancer Survivors Day. I read through dozens of posts from friends and patients. I watched most closely the posts and reactions from those I know living with mets. I always wonder how they would feel about my celebrating this life, and I worry. But something I heard recently, from Brené Brown because I'm on a kick, touched on the fact that our experiencing joy gives room for others to grieve and acknowledge that their pain is significant. That other people's pain matters because this life is so worthy of celebrating. I am paraphrasing greatly, so I hope I'm doing her words justice.

How do you define survivorship? Does the word ring true for you, or do you turn away from it and find it divisive? Why or why not?

I'm Just Here for the Endorsements

What a warm welcome back to this space! Thank you guys for being here while I dust things off and clear out the cobwebs and find my voice again. Why did I go silent for so long? Didn't the metastatic breast cancer community still need advocates?

Am I just back because I want your attention (not to mention the bazillions of dollars in endorsements)?

All joking aside, I do want your attention. God knows cancer still needs advocates, especially in the metastatic community. But I also want to shed light on what it's like to survive what I thought was metastatic cancer -- even the ugly parts. Especially the ugly parts, so maybe they can be less ugly for those who come after me. (Because I would fucking love it if all my mets friends suddenly found out they didn't actually have tumors breaking their ribs, filling their lungs, invading their brains, that instead they, too, had an autoimmune disorder.)

I want to talk about the dark parts of facing a major identity change, even if that change is ultimately a positive one. Yay, no cancer! Go on your merry way, we've got other patients to treat! They include your friends, who will continue to die. You should be so HAPPY! I digress, but maybe in talking about it, the darkness can be less jarring and raw going forward.

For so long, I wasn't ready for that amount of processing here, even if I've alluded to some struggles. I wanted to wait until I'd been in therapy long enough not to just dump everything out here without a filter. You guys deserve a little bit of a filter.

Scan-day, December 2018

Also, I haven't exactly known what to say. Should I write that this past year has run me ragged and bowled me over with a strange mix of joy and sorrow all at once? Babies are amazing, exhausting little creatures. Then, seemingly overnight, they turn into toddlers who are bonkers and feisty, and ours also has the gift of fearlessness. She runs and climbs and tackles our cat or practices for the World Rugby Championships twelve hours a day until I think I might pass out from the effort of keeping up with her. In the middle of it she naps, and I am addicted to the sweaty curls at the back of her head when she wakes up. Wash, rinse, repeat.

Should I mention that more than once, I've broken down in sobs while rocking Noelle to sleep because I am immediately transported back to the fear I felt when Quinn was her age? That my brain frequently tells me I may only have a few days/weeks/months left with my children, probably because I spent 5 years thinking my time was severely limited? Is that normal? Are the nightmares?



And I'll pause to reflect on what I know is true: I am very lucky. Not only were my mets not actually tumor cells, but then my body grew something surprising and miraculous and beautiful, even after the assault of chemotherapy on my reproductive system. While I hope that part of my story -- my motherhood story -- offers a bit of hope and resilience about what our bodies are capable of, I know it will also be a painful reminder of what can't be for many of you. And I don't want you coming here to feel triggered. Nobody needs that, and I get it if you can't stick around.

My therapist believes I have PTSD, which I thought was only for soldiers who'd been in war. I don't even like the battle metaphors associated with cancer, but apparently the mental health outcome can be similar. I am working on new therapies to help, and mindfulness practices to lessen the severity and frequency of panic attacks. I am exercising daily, but like a good friend said recently, I can't spend all my time in the gym. I may need other tools. I'm not ruling out medication. I met with a new therapist who is recommending something called EMDR, and I'll write more about that soon.

Should I tell you that I've had to step away from social media upon realizing some people in my circle are no longer closeted bigots, and so I have occasionally missed the news that a friend has gone into hospice, or worse? Not to mention the woman I thought was a friend who seemingly faked having metastatic cancer and has rocked this community? That I still feel intensely and excruciatingly guilty that I appear to have survived am surviving cancer?

Do you want to know that I joined a board to lend my patient voice to improving diagnostic accuracy because medical mistakes kill as many people as breast cancer each year, and my story has a rare, healthier-than-I-started ending?

All of the above?

I do feel like I owe it to myself and my twelve loyal readers (hi, mom!) to write about the emotional fallout of learning of my misdiagnosis, becoming unexpectedly pregnant, and then parenting from a completely different perspective, albeit with somehow just as much anxiety.

It isn't surprising that enormous changes in identity can wreak havoc on one's mental health.

I also feel like I owe it to the MBC community to continue to advocate on behalf of the women and men who are still dying at an alarming rate. At HealtheVoices a few weeks ago, a woman said we need to find our tribe, and all I could think was, "What if your tribe keeps dying?" I looked at the ceiling for awhile to help me blink back tears. I miss my friends.

So I'll be ramping up my advocacy work this summer, and I hope to share my story in more ways, across more platforms, as I heal from the trauma of my misdiagnosis and rediscover myself. I've missed you guys.

How to Talk to Congress

I am way out of practice when it comes to trekking in heels all over the unforgiving, marble halls of Congress. When I went to DC last week, I thought I was being sensible with 2-inch pumps instead of the stilettos I wore in my twenties. I was wrong. My feet are still healing from the ensuing blisters.

Was it worth it? To the extent it meant getting in front of legislative staff for my Senators and telling them my story -- absolutely. I'm not sure if I changed any minds, but here's what I can report and some advice for talking to your own Senators, whether you can make it to DC or not. 

Here I am after meeting with Helen Heiden, legislative assistant for Sen. Jeff Flake (R-AZ). 

I'd like to think this meeting had something to do with the decision to delay the vote on Senate healthcare legislation until after the 4th. Either way, doing my part to #ProtectOurCare by telling my story to staff of @jeffflake

A post shared by Jen Campisano (@jencampisano) on Jun 27, 2017 at 11:00am PDT

I realize I look slightly annoyed. Some of that may have been my sore feet, but it's also the fact that Senator Flake has not said one way or another how he'll vote on the proposed replacement bill for the Affordable Care Act. This legislation, called the Better Care Reconciliation Act (BCRA for short), will gut Medicaid spending by nearly $800 BILLION, allow states to opt out of the requirement that insurance companies include essential health benefits (EHBs) in their plans, and give massive tax cuts to the wealthiest people in this country. It is hardly a healthcare bill.

For Arizona alone, the proposed legislation would cost more than $7 billion over the next ten years. More than 400,000 Arizonans would lose coverage. We are a state that expanded Medicaid services under the Affordable Care Act, and it has been a success story. As Sen. McCain's staffer put it to me, "We don't want Medicaid to change in Arizona! Enrollment is up, and costs are down. It's exactly what we want to see." Even our governor, Republican Doug Ducey, has spoken out against the current draft of the Senate legislation.

Over this July 4th recess period, new proposals to amend the BCRA have emerged, including an amendment by Texas Senator Ted Cruz that would strip the few remaining protections for those of us with pre-existing conditions. This proposal makes the legislation even worse for the estimated 16 million cancer survivors in this country, not to mention all of the people with other conditions -- such as diabetes, asthma, high blood pressure, anxiety, and the like -- who would no longer be eligible for affordable care. The Cruz Amendment sounds dreadful, but has been hailed by a few more conservative senators as a requirement for moving this legislation forward.

So what can you do to help stop this? How can you talk to your Senators about this legislation?

• Call. I have my own senators' DC and local numbers programmed into my phone, and make a point to call and talk to a staffer every day. You can also call 844-257-6227 to be connected to the senators in your state.
• Write letters. 
• In any case: identify yourself as a constituent. Be polite, be brief, but make sure to share your personal story about why gutting Medicaid, or defunding Planned Parenthood, or stripping protections for pre-existing conditions or essential health benefits is bad for you and your family.
• If you can't think of how this affects you personally, feel free to share my story. Or my friend Danya's, who also lives here in Phoenix. 

After my meeting with McCain's staffer last week, I pressed the button for the elevator, and out walked Senator McCain himself. I introduced myself, and said I was in town from Phoenix to talk to his staff about my experience as a cancer survivor. "I'm one, too," he responded as he shook my hand. "I know, sir," I said, then explained to him that I hoped he'd continue doing what's best for Arizona and voting against legislation that's not good for cancer survivors or our state.

And if your senators are opposed to this legislation? Please still call them and share your stories. They need to hear appreciation for their stances, and need to know why this matters so very much.

Well Played, Universe

Exactly one year ago, I was lying in a PET scan machine three months after being taken off of the targeted chemotherapy I'd been on for almost three years. The next day, on the summer solstice, I received the news I shared here last October. You can go re-read it. I'll wait here and hope the link works as planned. 

I didn't think much could surprise us after what we've been through the last several years. Stage 4, metastatic breast cancer at 32 knocked the wind out of me. Being re-diagnosed with early-stage breast cancer and sarcoidosis made us feel like we were living in an episode of House. It took me nearly six months of therapy to be able to talk about it publicly. Talking about chemo-induced menopause and diarrhea had been easier.

Telling my cancer story at the Story Half Told launch in NYC, September 2015

Three months ago, the universe handed our family another earthquake: a very surprising positive pregnancy test. (When I say I'm good on surprises, the universe laughs. Well played, universe. Well played.) I had wanted this for so long, and mourned several times over because I figured it wouldn't happen again after all my body has endured. I knew I was lucky, though, and I think it's clear that I am intensely grateful for the boy wonder I do have. We had made peace with our family of three, but apparently Mother Nature had other plans.

So I reached out to no less than a half-dozen doctors (including friends who are doctors) in various fields about whether this was a good idea. Was my body healthy enough? Would the baby have 3 eyes? Will my cancer come back?

Every single one gave me the green light. An ultrasound at six weeks showed me the heartbeat and I sobbed into Chris's shoulder on the couch that night, still terrified about the potential risks or tough decisions we might have to make.

Tests at ten weeks said we were at low risk for chromosomal abnormalities and that it was a GIRL. I couldn't help it -- visions of the women's march and the sign I'd carried announcing "The Future Is Female" flashed through my mind.

My heart is feeling inspired and uplifted today witnessing millions marching for women's rights around the world, and participating here in Phoenix with these powerhouses. #thefutureisfemale #womensmarch #resist

A post shared by Jen Campisano (@jencampisano) on Jan 21, 2017 at 3:19pm PST

Was it fair to bring another woman into this world at this ominous point in time? I just read The Handmaid's Tale. There is legislation brewing as we speak that will make this pregnancy just one more preexisting condition to add to my list.

Another test at fourteen weeks said we were unlikely to see neural tube defects. What about breast cancer? I thought to myself. Can we put an end to cancer before she has to worry about it? Can they confidently tell me she'll be okay? That I will? Would I really want to know otherwise?

And earlier this week, we had an early anatomy scan, the high-resolution ultrasound that checks that all major body parts are developing properly. She does not appear to have three eyes. She seems perfect, if a bit camera-shy.

I'm midway through week eighteen and definitely sporting a bump that no longer looks like I just ate too many burritos.

We are in the early stages of figuring out how to remodel our house to accommodate a baby, who is slated to join our family around mid-November, just in time for Thanksgiving. I am grateful, I am more fired up about social justice than ever, and I am scared about my capacity to love another being as much as I love Quinn. He tells me I just will, that my heart will grow into it.

Photo by the remarkable Pei Ketron for Story Half Told

So Long, 2016

A lot of people in my circles can't wait to see the end of 2016. And it's not just my circles, is it? By so many accounts, 2016 was a dumpster fire of a year:

So ingrained had 2016-cum-terrible-horrible-no-good-very-bad-year become in our broader consciousness that it came to stand in for something larger than itself: 2016-ness. On Election Day, British writer Owen Jones captioned a GIF of a mushroom cloud: “Just how 2016 is 2016 prepared to be?” He added later, when the early results were favoring Trump: “2016 currently thinks there is ample 2016 to go. 2016 is currently saying ‘heyyyyy! Look how 2016 I can possibly be!’ ”

Other people are all over Twitter talking about celebrity deaths, which were exceptional in 2016, I'll give you that. George Michael, Carrie Fisher, Prince, David Bowie. Us children of the '80s grieved the stars of our childhoods. But every year, women I know and love are dying, too.

This year started out for me as so many Januaries have since my diagnosis, with the death of my friend and advocate extraordinaire, Holley. At the time, my nurse told me that deaths tend to spike in January, patients having held on through the holidays. Without giving it much reflection, I can immediately think of five other good friends of mine who died of metastatic breast cancer in 2016: Colleen, Amanda, Michelle, Lesley, Jody... And the mushroom-cloud GIF embodiment of 2016 doesn't seem that far-fetched.

Holley & me at the opening of A Story Half Told in NYC, in October, 2015, 3 months before she passed away

On the other hand, a hand I envision rising out of the ashes of the bomb that was this year, I can't close out 2016 without reflecting on what a miraculous one it was for our family. 2016 will always be the year I was told I don't have metastatic cancer. 2016 was the year I got to celebrate my 20-year high-school reunion and had my port removed after almost five years of chemo infusions. This year I got to see Quinn start kindergarten, learn to ride a bike without training wheels, and lose his first tooth. 

And this was the first holiday season of Quinn's life that I haven't constantly wondered if it would be my last. 

***

For the past several years, we've participated in a winter solstice ritual introduced to us by our friend Kaye. Some years, she hosts a gourmet, multi-course meal at her home, and over after-dinner drinks we write our wishes for the coming year on scraps of paper. We don't share our wishes with each other, though I suspect everyone in the room always knows what my wish for the coming year is. Some years, I was bald. (Hint: I never wished for hair.) Kaye would say some words about the significance of the solstice and the coming of the light, and we would all light our wishes on fire, unspoken, rising to the heavens to be doled out from there.

I've had some setbacks over the years since my diagnosis, but my wish always seemed to hold. I imagine it is the same wish of most people with a diagnosis of metastatic cancer. This year, we didn't get together with Kaye, but we had friends visiting from DC and shared our new tradition with them. We lit our wishes on fire on our back porch, laughing that some didn't seem to launch far from our patio table. Of course, I hope they still come true, whether they made it to the heavens or not.

The winter solstice was my in-law's wedding anniversary. My father-in-law died of metastatic pancreatic cancer in the fall of 2009, just shy of what would have been their 35th anniversary. Six years later, my mother-in-law died of complications from Parkinson's disease. Sometimes, when we light our wishes on the winter solstice, I wonder if my in-laws aren't still looking out for us, granting us another chance to wiggle a loose tooth or play Santa for our boy.

***

On December 23rd, I paused to remember that same date in 2011 when I was told for the first time that the chemo had worked and there was no evidence of disease. Earlier this month, I was officially re-staged. After a clean scan mid-month, my oncologist told me I'd probably been stage 2B. My sister-in-law commented that I was probably the only person ever to be happy about a stage 2 cancer diagnosis.

2016 was the year I got to wipe the slate clean and say I've probably been in remission since December 2011 -- 5 years now. While that number doesn't hold much meaning for me in terms of magical cancer milestones (I've seen far too many people recur after reaching five years "cancer-free"), I am in awe that I'm still here. I pinch myself nearly daily at the twist my life has taken this year, at the new chances I've been given. 

It was just the three of us -- Chris, Quinn, and me -- this Christmas, we spent it in our pajamas until dinner, playing with new toys and eating Santa's leftover cookies. It was a pretty perfect celebration of life and re-birth, even if we're not churchgoers.

Tonight, we'll ring in the new year and say good-bye to 2016 with some friends and champagne. I'll make a toast to what a crazy, mixed-up, sweet, miraculous, dumpster fire of a year it was. I'll hope for many more miracles in 2017. Cheers, my friends. I love you guys.

Photo by the exceptional Lara Agnew

Get Out And Vote

I wasn't sure I was going to write about this election on my breast cancer blog. I mean, what does politics have to do with cancer or healthcare? Quite a bit, actually.

My dear friend Beth is currently in a fight for her life because her insurance company, a federally-run group, has denied the combination therapy that her DOCTOR recommends she have to treat her metastatic breast cancer. You see, the drugs are not FDA-approved for use in this way, even though trials have shown 93% efficacy in the treated population. Beth has taken her fight to social media, and as a community, we are stepping up in the hopes that +Blue Cross and Blue Shield Service Benefit Plan will hear our voices and #SaveBeth.

It's gross, really, that an insurance company can say no to life-saving drugs.

Here's how it's supposed to work: 1) Patient pays for insurance 2) Patient gets sick 3) Insurance pays for treatment. THAT'S WHY WE HAVE INSURANCE. It's why we PAY for it.

Insurance denials by federal insurers are a policy issue. FDA approvals are a policy issue. Cancer research and how much money gets funneled into research on metastases (not nearly enough, only about 7%) is a policy issue. Policy gets set, for the most part, in Washington, DC. And for cancer patients and survivors, those issues are vitally important.

It is literally about life and death.

I cried tears of relief last year when the Supreme Court ruled in favor of the Affordable Care Act's protections on coverage for those with a pre-existing condition. I didn't know then what I know now about my health: namely, that I was likely never metastatic. But I still will always have had cancer. It is part of my story now, and prior to this monumental ruling, insurance carriers could flat out refuse to cover me.

I have my insurance through Chris. It has been wonderful insurance, covering most of our costs over the past five-and-a-half years, which have included a c-section, a bilateral mastectomy, nearly EIGHTY infusions of chemo or targeted chemotherapy, several biopsies, five weeks of radiation, more scans than I can count, and reconstruction. I have no idea how much all of that has cost, but my guess is Chris and I couldn't afford it out-of-pocket. 

The thing is, our insurance is tied to his job. I think his job is secure, but surprises happen in life. [UNDERSTATEMENT OF FOREVER] If something happened to Chris, would I be eligible for insurance coverage? The Supreme Court says yes. But Republicans have vowed to overturn the law that protects this coverage. I'm not okay with that uncertainty.

Republicans have also promised to defund Planned Parenthood, which provides free cancer screenings for underserved populations. DEFUNDING THAT CARE IS NOT OKAY. Women of color are already at such a disadvantage when it comes to healthcare. Struggling populations don't need one more hurdle standing in the way of their survival.

A republican congress has also drastically cut spending on science over the last decade, and would likely continue to do so. Science is how we get research. It's how we move toward therapies that keep patients like my friend Beth alive long-term. So she can watch her young kids grow up. So she can continue to advocate for other patients living with this dreadful disease. So we can end cancer as we know it.

But this election isn't just about me. It isn't just about cancer. And it isn't just about democrats versus republicans and who promises what.

It's also about the most qualified candidate in my lifetime to run for office, going up against an unprepared clown who seems to think our constitution is a joke and derides nearly every group of people imaginable: women, disabled people, Hispanics, Muslims, Jews, blacks, even those in his own political party. I honestly don't understand the appeal.



This election is about the tone we will set for our country for at least the next four years, but possibly a generation or more. Our kids are paying attention. Quinn tells me I should be president, but short of that, he doesn't understand why a mean person, a bully, would even have a chance. Quinn is in kindergarten and understands that's not how we get ahead in this country. Those are not the morals we defend. We are better than that.

As one of my favorite bloggers put it:

I'm begging you:  please go vote, and please vote with best intention.  I suspect that I don't have to convince you that this man is a demagogue -- I can't imagine you'd be visiting Chookooloonks if you agreed with his stance.  However, if you're eligible to vote in the United States, I beg of you to do so.  Vote early, if you can; if you can't, then on Tuesday, November 8th, please find your way to the polls, despite the weather, despite the lines, despite how busy you might be.  And as you vote, please be mindful:  please don't throw away your vote, and please don't vote for this person simply because you're loyal to his party.   He's a dangerous, unkind, mean man, and he doesn't deserve your vote just because he conveniently chose a major political party to hang his platform on.

There are so many important issues facing our country. Healthcare, the future of our treatment of cancer, and the first amendment are just a few important ones to me. I'll probably lose a few readers because of this post, but it's important. I can't keep silent on it, not this year, not this election. 

Please remember to vote tomorrow. Our lives depend on it.

An Announcement

Last Friday, Quinn's class had pajama day and an ice cream party to celebrate the number of "class compliments" they've received since kindergarten started eight weeks ago. He has grown up so much these past couple of months. He's made new friends and started to find his way at a big, new school with big, new rules. He is learning to read, playing soccer now, and asking for time with his friends more and more. Our dynamic is shifting, and I'm trying to breathe my way through it.

But after school last Friday, he went to the bathroom, then walked around the house in his pajama top and underwear, sending me straight back to his toddler years when he refused to wear pants at home. A glance at his thighs alone had me in tears before I knew what hit me: a nostalgia for what wasn't, for something we'd missed, for a past I can't change.

I spent that evening watching old videos of Quinn: swimming, opening Christmas presents, on our way to adopt our first dog (the one that ended up biting him in the face), telling me I was his best best friend forever. I am a puddle of emotions. How is he five and a half? Again, I borrow from my friend talking about losing her mom: "Two years ago today my sweet mama bear was diagnosed with ALS. Two years. Two years. Two of the longest years of my life. Two of the shortest years of my life. Time bends and twists and deceives the eye and heart and mind. Time, you weirdo contortionist." Time is a weirdo contortionist.

What might it be like to raise a child and not have the fear of cancer looming over you every moment? How might those early years have been different? How might today?

This is one of the hardest posts I've ever written.

***

You guys know I haven't written here much lately, and I haven't posted a health update in months. I know you've noticed. Some of you have asked, and I've been vague.

I haven't known where to start. I've wanted to be certain, as certain as one can be when talking about one's health, anyway.

Chris always tells me to start with my elbow.

A skin biopsy at the beginning of the year led to questions about my cancer staging. My oncologist wanted to take me off chemo based on the results, which came back as something called sarcoidosis. I wasn't ready to let go of my chemo safety net. Not because of a pea-sized thing on my freaking elbow.

Then I had a scan in March that lit up like a Christmas tree: in my chest wall, my abdomen, my left lung, my spine, the list goes on. I walked out of my oncologist's office as he was handing me the radiology report. Fuck this, I thought. How does anyone deal with cancer progression? How does one face their spouse after news like that, without exposing every fear simmering under the surface? You just hope your partner is a little stronger than you in those moments. Because one of you must steer the ship, and after reading "likely for metastatic disease" in about five different places, I was in no position to steer anything. Afterward, you hope that your partner will take you out for a drink even though it's the middle of the day.

He does, bless him.

Over the next couple of weeks I underwent a slew of tests to determine what was happening in my body. A spine MRI and a pelvic ultrasound were both "unremarkable" despite showing activity on my PET scan. A lung biopsy left me with a partially collapsed lung and a twelve hour hospital visit, but the results were benign: a granuloma with characteristics of sarcoidosis.

Not cancer. Not this time, at least.

I went for a second opinion at the Mayo Clinic. What the fuck? was my basic question to the oncologist there. "If this is metastatic breast cancer, it's the strangest case of it I've ever seen," he told me, after reviewing my scans from the last four and a half years. "We don't tend to see recurrence after a pathological complete response like you had, not with Her-2+ disease."

Where had he been the last several years of my life?

***

Sarcoidosis is an autoimmune disease that causes inflammation -- typically seen in the lungs, skin, and lymphatic system. They don't know what causes it. Bernie Mac died from complications of it, but it's usually not fatal. While it sometimes goes into remission on its own, the treatment for sarcoidosis is steroids.

Like the ones I'd received with every single chemo infusion over the past fifty-four months.

Three doctors agreed on a course of action: take a break from treatment and re-scan in three months. Those months were a series of panic, panic, Xanax. Like a bad game of duck-duck-goose.

And then my three month scan came at the start of the summer. It was clear as a bell. Clean as a whistle. The radiology report suggested a "complete response to interim treatment," except there hadn't been any interim treatment.

Metastatic cancer doesn't clear up on its own.

I cried big tears in my oncologist's office, part relief, part are you fucking kidding me, part hope that any one of my doctors knew what they were talking about. "I hope those are happy tears," he said. "It's not every day someone gets a miracle like this. This is better than winning the lottery."

To which I say: yes, mostly. I imagine it's also like being wrongfully imprisoned and then released after nearly five years and told to go be happy. I am happy, but this news has required a lot of processing. Like, a shit ton of therapy. I'm still processing. I'm still a puddle of emotions every time I catch a sunset. Or a glimpse of Quinn's thighs.

***

As the news -- that my so-called metastases have always likely been sarcoidosis -- sinks in and starts to seem more real, I have continued to advocate (albeit a little more quietly) on behalf of the MBC community. But it has come to a point where I feel like in order to amplify my voice and those of my friends living with mets, I needed to be able to do so in a way that upheld my integrity, that allowed me to be my most authentic self.

I haven't been restaged, but if I had to guess based on the size of my original tumor and the number of lymph nodes removed during my surgery, I was probably Stage 3A. I don't know if I'll ever know. As one new friend recently put it, "I will always consider you a Stage 4 survivor." But I am no longer considered a metastatic breast cancer patient.

While I have superb insight on what it feels to be one, I feel it is only fair to withdraw myself from Pfizer's Story Half Told campaign, which aims to shed light on the lives of women living with metastatic breast cancer. Pfizer's team has been more than patient with me on the timing of this announcement. But I know that October will be a big push for the campaign and the stories of the women involved. I could not honorably continue as a face of MBC after learning the news I've learned this summer. In no way do I want to distract from my friends who are facing this disease day in and day out.

I will continue to do whatever I can to bring awareness to the men and women living with MBC, to advocate for more research funding, and to bring hope to people that there is life after a terrible diagnosis. In some cases, the details of that diagnosis may even be a terrible mistake. If my story isn't a plug for second (and third) opinions, I don't know what is.

To the few of you who've shared these past few months with me in silence, thank you for holding space for me to grow into this new reality, and for supporting our family as we learn what it means to start over. To the rest of you who have been such a godsend of strength to us these past five years, thanks for standing by us as we adjust to life after cancer.

I always wanted to be an outlier, I just never imagined it would be in this way. Here's to more sunsets. Here's to the ultimate mulligan. Here's to hope. Here's to first grade...and beyond.

What Does the Beast Mean to You?

From left to right is Sheryl, my friend from college JT, me wearing a reminder sash that someone is diagnosed with breast cancer every 3 minutes in this country, and Ginelle, just after finishing our first Avon Walk in Santa Barbara in 2012. 

I was on a training walk with my friend and team co-captain Ginelle a few weeks ago while visiting her in San Diego. It was Mother's Day, and our conversation ran the gamut from our kids' friendships  and education in public schools to taking care of our mental health to the upcoming election, god help us.

This is how these types of walks tend to go when you're on the trail with a woman who has seen you at your literal worst, who has filled your freezer with homemade chicken pot pies and made pureed organic baby food for your 8-month-old, whose friendship has grown out of an openness and willingness to talk about issues that sort of surprised me when was first getting to know her.

Several miles into our walk, she said to me, "You know, I've been thinking about what the beast means to me." At first, I didn't know what she was talking about. It took me a second to catch up. Then it dawned on me. We call our team "Team Booby & the Beast."

"You mean, beyond cancer?" I asked.

"Well, yeah," she said. "Since you're doing better, it's taken on a bigger meaning to me. It's not just about your cancer or anyone's cancer. I think of it almost as the struggles we face as women. The burdens we carry, particularly with the election we're facing. Don't get me started on that."

I did get her started on that. We talked about Trump and the setbacks his presidency could mean for women. We talked about her daughters and my son and what we want them to know about their bodies, their abilities, the people they share this world with, and how to teach them respect for all of it. We talked about women who work, and women who -- like us -- stay home with our kids but used to have careers outside of motherhood. We talked about how lucky we are for the healthcare we have. We talked about privilege. And the disadvantages that still exist for women.

Recently, in two separate posts on social media, I was brought to tears about the struggles women still face in our society, not to even mention other societies. One was about a book on evolutionary biology with contributions from some of the top experts in the field, which failed to include a SINGLE female voice, even though I know plenty of women scientists and I am not even one. Second was this video that just speaks for itself about where women are in the world today.


***

This weekend, I am in Chicago with Ginelle and seven other teammates -- men and women -- to walk in my fifth Avon Walk, 39.3 miles over two days to provide funding for both research and underserved communities affected by breast cancer. I am pinching myself that I get to do this, that I am still around 5 years after my diagnosis, that we have so many supporters we have raised more than $32,000 and are currently ranked third for team fundraising in all of Chicago. I'm a little proud.

As I was packing for our trip, Quinn turned to me and said, "I can't wait to see you walk in Chicago, Mom!" I was surprised by the tears that poured out of me. I walk for him, after all, and this is the first time he'll be around to cheer me on. I pulled him in for a big hug and wiped the wetness from my cheeks.

Cancer, specifically metastatic cancer, will always be my beast. It is the thing against which I rail -- in whatever small way I can make a difference -- until my friends stop dying.

And I love that my son gets to see this side of me. He is old enough now to understand a bit of what it means to give back, to do something greater than yourself, to start to understand how breast cancer changed our lives. Earlier in the day, he had asked me if everyone in the world knew about the Avon Walk.

Ha. Not yet. Not even everyone knows about metastatic cancer, but we are working on that.

***

A number of patient advocates and friends of mine are also in Chicago this weekend, gathering to share their stories and insights with researchers at ASCO, the American Society of Clinical Oncology's annual meeting. I wish I could do both. Instead, I will be checking my Twitter feed regularly for updates on precision medicine, immunotherapy, advances from the Broad Institute, and quips from the brilliant women I get to call my friends.

Here we go, Chicago.

Radioactive

Scan day kind of snuck up on me this time around. I didn't really think that was possible, but more than four-and-a-half years in, this path I'm on still surprises me.

And it's been awhile, so my oncologist ordered a PET/CT instead of just a CT. 

My very basic understanding of the imaging processes is that a CT scan exposes me to less radiation (but still something like 6 months' worth of normal everyday radiation, all in one sitting). Using x-ray technology, a CT scan shows cross-sections of my bones, organs and tissues, as if I'd been cut into teeny tiny slices. If something abnormal -- a tumor, say -- were present, the images would show where and give my doctors a pretty precise idea of its size.

In a PET scan, by contrast, I show up to the scan after fasting all morning and avoiding carbs the day before. (I AM FREAKING HUNGRY AND I NEED COFFEE.) Prior to the scan, I'm injected with a radioactive glucose, the idea being that any cancer cells would eat it up and then light up on screen. This "uptake" is then measured to give doctors an idea of how active (or not) any cancer is. There's quite a bit more radiation exposure with a PET scan since, well, they INJECT ME WITH RADIOACTIVE GLUCOSE.

(That tube right there is connected to my port; that radioactive sugar -- stored in that lead capsule to avoid exposure to the technicians -- is going pretty straight to my heart.)

In fact, I'm specifically told not to be in the vicinity of children under the age of 12 or pregnant women for four hours after leaving the hospital.

I don't know why, but this fact makes me extra emotional.

***

Chris and I were discussing logistics yesterday while Quinn was in the car. Quinn has heard so much in his five years. My medical issues are a part of our day-to-day lives and lexicon, and I don't often think to filter myself, especially when to some degree we're just talking about pre-school pick-ups and doggie daycare. I was telling Chris that since I'm supposed to avoid pregnant women and children for four hours, it might be best to take the puppy to doggie daycare, too, to avoid risk to her. Out of an abundance of caution.  

Somehow, this is where Quinn's ears perked up. "Why can't you be around kids?" he asked from the backseat.

"Because some of the stuff they have to put in me for the pictures they're taking is radioactive, and it's not safe for you to be around. But it'll be fine by the time I pick you up from school," I said.

"What's radioactive?" 

At which point Chris chimed in, trying (I think) to be funny but also to educate our 5-year-old. He is, after all, a professor of geology. "Radiation is the energy released when an unstable isotope of an element changes to a stable isotope."

"Huh?" Quinn and I both said.

"Um, it's just something to help them look inside mommy, like an x-ray, but stronger, and it means I can't be around you for a little bit. You'll be at school so you won't even know the difference," I tried. 

"But you can't be around me for four hours," Quinn said, clearly getting anxious about it.

"I don't want you to worry about that, buddy. Four hours is like the time from when I usually drop you off until when your friends have nap time. Please don't worry," I said.

"It's really hard not to worry about it," he said, and my heart broke open a bit, again.

I turned around to hold his hand, then. "Please don't worry, okay?"

Please. Don't. Worry. Don't worry about mommy leaving you, about my scans, about anything at all, my little man. My child.

***

So this is Monday. This is so many days. I hate cancer.

Honored and Humbled

I received a surprise email last week, letting me know I'd been chosen as one of Healthline's Best Metastatic Breast Cancer Blogs of 2015. I didn't even know my blog was being considered! The email went on to say that "Healthline’s editors carefully selected each winner based on quality, frequency of updates and contribution to the community. You can see the full list here: http://www.healthline.com/health-slideshow/metastatic-breast-cancer-blogs."

I am beyond honored to be included among some of my favorite people in this community. It's a community none of us wanted to be a part of, but here we are writing through our experiences, sharing our hopes and fears, and even advocating for change in the research world. If you're reading this, I encourage you to take a peak at some of the other honorees' sites. These are some badass women. 

And I do think we're collectively starting to make a difference. People in high places are starting to take note of the plight of those living with metastatic breast cancer. I, for one, can't wait to see the end of MBC as we know it. We're not there yet, but just since my diagnosis four-and-a-half years ago, the average life span is already starting to increase for those with mets. 

HURRY UP, RESEARCHERS!!!

I received this fancy badge to embed on my site, which you may have noticed on the sidebar. I'm humbled, and honored, and so incredibly appreciative of your support -- my readers, friends, and family -- over these past several years. Thank you for keeping me going.

Thirteen days after my diagnosis, I started this blog. I started my first round of chemotherapy (Taxotere, Carboplatin, and Herceptin) the next morning. I was scared out of my mind, but eager to eradicate this beast inside of me. Initially, I intended my blog to be a means of communication when medical information was seeming to come in at warp speed. A good friend suggested it, and I thought it would be easier than sending the same email to concerned friends and family a hundred times over.

I never expected my little space on the Internet to blossom into what it has become, a therapeutic outlet for me that has also embedded me in a powerful community of thrivers and advocates, moms and can't-be-moms, daughters, sisters, and wives. I didn't expect I'd have my heart broken so many times. I didn't even really expect to still be here nearly five years later. I didn't expect that I'd have strangers reach out to connect with me through the ether to tell me their stories and say thanks for sharing mine. Words have so much power. Thank you for reading mine.

I Am Out of Words and My Heart is Broken

You'd think that with upwards of 112 of us dying every. single. day, the blows wouldn't be quite so crushing at this point. That perhaps we'd get used to it. Become numb, maybe. Like the rest of the world sometimes seems to be to our plight.

But every so often, a death (or group of deaths) comes along and it feels like we've collectively been punched in the gut. Our hearts ache. We are angry, and scared, and fucking tired. But we know we've got to carry on this fight -- even as we receive chemotherapy and take care of our children and look into clinical trials and try to enjoy every moment because we know more than most how limited time can be -- because who else will fight for us?

Who?

Forty thousand American women lose their lives every year to breast cancer, and yet researchers at the San Antonio Breast Cancer Symposium -- the LARGEST conference in the country addressing breast cancer research -- had almost nothing to say about metastatic disease this year. I was there. I waited for a breakthrough announcement. I listened to the recaps afterward, hoping I'd missed something significant.

Instead: "The mets research isn't ready for prime-time," is what I heard.

How long do we have to wait? Since my diagnosis, approximately 173,333 women have died of breast cancer in the U.S. alone.

"How can we express our urgency?" we asked.

"We get it, just keep doing what you're doing," we were told.

BUT CLEARLY IT IS NOT "GOTTEN" when nearly 8,000 clinicians can gather and have no news about stopping metastatic cancer, the only breast cancer that kills. Instead, we hear case studies about drugs extending our lives by a few months. 

A few months doesn't get me to see Quinn start kindergarten. A few months is not even close to enough. 

A few months ago, my friend Adrienne was told she had no evidence of disease. She took her little boy to Disney World.

On Saturday morning, she died of metastatic breast cancer that caused her liver to fail. Poof -- gone, just like that. Another little boy to grow up without a mom. A dad left to explain how she would have stayed if she could have. Another young woman dead long before she should be.

I am angry, and I am terrified. And this weekend, I felt like maybe we as advocates aren't doing enough to make our voices heard, like we let Adrienne (and about six others in my direct circle this week) down. But we can only do so much. We are exhausted, and doing our best.

Who else will fight with us?

I am at chemo today, 4 days before Christmas, wondering how I'm going to get everything done that needs to be done this week to create magic for my little boy because that's what my parents did for me, but also feeling so very lucky just to be here another holiday season. How deranged is that, to have to wonder about whether this Christmas might be your last because the average lifespan after a metastatic breast cancer diagnosis is 33 months.

At 52 months and counting, I am on high alert for when that other shoe might drop. Yes, I have hope I'll be here long-term. But I also know the realities of this disease. They've been especially hard to face this past week.

Quinn asked me what was wrong several times on Saturday, as I sank to the kitchen floor in my grief or cried as I heard the lyrics, "Home is wherever I'm with you..." on the radio while we tried to get in some last-minute Christmas shopping. He offered me big, strong, bear hugs, and all I could manage to tell him was that a friend of mommy's got some bad news.

What else is there to say to a four-year-old?

The truth is, I do not know what to say anymore. My heart is broken. Shattered in about 112 pieces today alone.

Please, please help us.

The Season for Hope

Many of you know my good news already, that my scans last week before Thanksgiving continued to show no evidence of cancer. What a way to go into the Thanksgiving holiday. And that sound you may have heard? That was Chris and me finally exhaling after 48 hours of holding our breath waiting on results.

As the stress started to dissipate, I came down with another sinus infection and had chemo last week (plus a lunch with Arizona's Governor -- a story for another post, maybe -- and hosted a cookie decorating party with a dozen or so preschoolers over the weekend), so I've disappeared a bit from this space. I've been busy living, which is pretty wonderful. I am so very lucky for this beautiful life.

Incredibly thankful for this goofy and handsome dude (who could almost not stop saying "turkey!" today). From our family to yours, happy thanksgiving. This life is such a joy. 🍁🍾😊

A photo posted by Jen Campisano (@jencampisano) on Nov 26, 2015 at 9:24pm PST

But I've also been hesitant to talk about my good news too much, in part because so many of my friends are facing disease progression, chemo regimen changes, or the unknown of clinical trials over the last couple of months. These friends post photos from hospital beds of them with their children, and my heart aches for them. Or they post that they have to leave their families -- now, at this time of year, just to emphasize the magnitude of the injustice of it -- to take part in clinical trials to try to put the brakes on their particular form of breast cancer.

Maybe this drug will be the one that finally stops it. 

Maybe this won't be my last Christmas with my kiddos. 

Maybe I can walk today, despite the pain in my bones from cancer's spread. 

I've become a part of this community. These women are my friends. My diagnosis wasn't terribly dissimilar to many of theirs. In some ways, it was worse, since I was metastatic from the outset while many of them thought they were safe with an early-stage diagnosis. My luck could change at any moment, and their stories could be my story. But for now, I'm relatively healthy.

That is no minor thing. As the saying goes, when you have your health, you have everything. I am so very, very lucky. I try to remember that every day.

***

As Quinn and I were putting up Christmas decorations the other day, listening to Holiday Classics on iTunes, "O Holy Night" started playing. We are not a religious family, but it's still my favorite Christmas song. I choked up, watching my son choose where to put ornaments and feeling beyond fortunate that I get to be here to see it.

And then I started crying as I strung the lights, thinking about my friends whose cancer situations are worsening or who are spending this season without family members because of cancer. The music wasn't helping. I'm blaming you, Mariah Carey.

Is this survivor's guilt? Can you really have survivor's guilt when you've been diagnosed with an incurable cancer? Do the holidays make everyone more emotional? Or is it just the sugar highs (and subsequent crashes)? Maybe I just need a break from Chex Mix.

***
Chris is in the town where he grew up the first half of this week, wrapping up things with his mom's estate: a visit to the DMV, a meeting with her accountant, closing of bank accounts, that sort of thing. We have had our own significant loss this year, and it is going to be a tough holiday without my mother-in-law around.

Later this week, I am headed to San Antonio, to attend a program as part of the annual breast cancer symposium there. I am hoping to learn about advances in research and new ideas in the pipeline for eradicating this disease. I am hoping to bring some more good news back to this community of mine, some more reasons for hope.

After all, it is the season for it.

A Million Thousand Hundred Times

The other night, as I was tucking Quinn into bed, I overheard him whispering to his favorite stuffed animal, Bunny.

"Mom, I was telling Bunny how much I love you."

"I heard..."

"I love you a million thousand hundred times," he said. Sometimes it's "to Pluto and back" or "to the Milky Way and back" or "to all of the planets in all of the galaxies." We have a theme.

"I love you that much, too," I replied, my throat catching. Some nights, his sweetness just floors me. Especially when I've got another scan around the corner and he is seeming to grow up more with each passing day. Can I freeze time? Keep that one tender moment locked in the safe space of my heart forever? Keep all of them there?


Quinn Tornado from Jennifer Campisano on Vimeo.

When I was diagnosed, I wasn't entirely sure I'd get to be here right now. In fact, I had a dream shortly after -- sometime in the fall of 2011 -- of  a toddler Quinn holding someone's hand at a funeral I was pretty sure was my own. The statistics said I had a one in five chance of living to see Quinn turn five, let alone see him start kindergarten. Only twenty percent of women in my situation would make it to the five year mark.

This week, Chris and I have toured three different elementary schools trying to decide where to send Quinn for kindergarten next year. For another time: when did choosing a kindergarten get so complicated?

But kindergarten. My boy.

And me. Maybe just maybe going to get the chance to buy him a new backpack next summer, go school supply shopping with him, see all that he has to show us as he learns even more clearly how to express himself.

It could happen.

Getting Our Affairs in Order

Shame on us, really, because we should have done this years ago. Along with finishing Quinn's baby book and organizing our family photos. See, also: throwing away leftover Halloween candy, drinking more water, and stepping up my cardio game.

But with the death of both of Chris's parents in the last few years (his mom just this summer), not to mention my string of luck health-wise in 2011, 2012, and 2013, it became more and more clear we needed to have our affairs in order. It sounds so final, to "get your affairs in order," but really, it's just the smart thing to do. I'm not planning on dying anytime soon, but you never know. That proverbial bus seems to be all over the place these days.

Also, I'm a lawyer. I know it's important to have an estate plan, if only to keep the courts out of things at the end of your life. Lord knows I don't want some Arizona probate court deciding what becomes of this guy, god forbid and fingers crossed and knock on wood. 

So we met with an attorney, who will draft a plan for us and set things up so that Quinn will be okay even if Chris and I both get hit by a bus. 

I held myself together through the meeting, despite having to talk about what happens if Chris (or I) remarries, who makes decisions if one of us is on life-support, who would get custody of Quinn, and whether you can legally enforce requests for certain included elements at a memorial service, such as the singing of "Ave Maria." (I think this last one was Chris's attempt to lighten the mood. I was trying not to choke on the knot growing at the back of my throat.) 

I know in lots of ways these are first-world problems. We have a house, we are educated and have a college fund for our son, and we have family to care for him should something happen to both of us, which is admittedly unlikely. But something about incurable cancer and making very concrete plans for the end of your life and having scans in two weeks came together to have me ugly crying in my husband's arms this weekend, asking him who would remember snack days at school for Quinn, or register him for soccer and swimming (and make sure he gets to both), or put notes in his lunch telling him how much he is loved? And would he remember that I'd done any of these things for him? Would he remember me? 

Oh, yes, I went there. 

My death is not imminent, I don't think. I am getting to be Quinn's mom, which has made me the luckiest person on the planet these last four-and-a-half years. Mostly, things are pretty good here. Other than cancer, I can't complain! Which is along the lines of the question, "Otherwise, Mrs. Lincoln, how was the play?"

But, oh, can mortality be a terrifying thing.