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Farmington woman recalls breast cancer experiences

Melinda Brown has been a Farmington resident since fifth grade; graduated from Farmington High School in 1985; and married her husband John, an Edward Jones financial advisor, in 1989. She is a registered nurse at Outpatient Surgery in Farmington, and with her husband, is the parent of two adult daughters. Oh, and one more thing … she is also a breast cancer survivor.

Brown’s battle with cancer began unexpectedly in the fall of 2013.

“Every October was when I would go and get my annual mammogram done, and I had one done the previous year,” she said. “I knew it was coming up.

"I had just been doing the self-breast examinations that they tell you to do in the shower every month. I felt something odd on the left side of my chest, but then again, I had been diagnosed with fibrocystic disease, so you felt a lot of lumps and bumps that they sometimes say might be related to your diet or just that you were more prone to developing them.

“So, I went to my appointment, and I just casually mentioned that I had felt something that I wasn’t really concerned about. It didn’t really cause any pain. She said we’ll just take an extra shot on the mammogram just to make sure. I had the mammogram done and she did the extra shot, and it came back that they had noticed a difference from the year previous and they were glad that I had mentioned that I had found something that I felt, otherwise they might not have taken that certain angle.”

The news Brown received from her doctor wasn’t at all what she had hoped for.

“The ultrasound came back that I had a cancerous lesion there. There were two spots that they had noticed,” she said. “Your immediate reaction when you hear that ‘cancer’ word — it’s just like your life flashes in front of your eyes. It’s the 'C' word. I thought about the girls and that I’d had a wonderful, blessed life and I wanted to continue it.

“So, John and I were like, ‘Well, you know what? This is what we’re dealing with. This is our deck of cards, so let’s just move forward and get things taken care of.’ This was in like October, in the fall … October, November … and we went in to get things done before the end of the year because we were also thinking financially that we had already met our deductible, so we wanted to get anything done before the end of the year.”

Brown’s doctor wanted to perform surgery and so she went to a radiation oncologist who wanted to do his own biopsies.

“We did that at Siteman Cancer Center,” she said. “They just noticed it in that left breast, but because I did have fibrocystic disease, they gave me the option of whether I wanted to have just a single mastectomy or if I wanted to opt to go ahead and have a double mastectomy. I thought, ‘Well, since I’m already in my late 40s and I hear about women in their 80s that develop breast cancer later on down the road. I can’t imagine going through this at that age so, I’m just going to go ahead and get this taken care of, so I don’t have to worry about it anymore.

“We went ahead and did the bilateral mastectomy first. After the mastectomy, they had put expanders in because I wanted to go ahead and get implants put in. We spend a lot of time on the lake wearing a swimsuit and I didn’t want to have to worry about that. My next step was going to be chemotherapy. I elected to do chemotherapy because they determined my risk factor of whether or not within five to 10 years, I might develop breast cancer again.”

Brown took part in a study through Washington University in St. Louis, but she didn’t receive a definitive answer as to whether or not chemotherapy would assist in her recovery.

“My risk factor came back right on the borderline,” she said. “I could either not receive it or go ahead and receive it. They wanted to leave it up to me.

"Since I was just on that borderline, I thought, ‘Well, I’m going to go ahead and get this done while I’m young. I went through eight sessions of the chemotherapy and did fine with the chemotherapy. I lost my hair. I felt healthier after my hair came out because it was just so thin and ratty looking. After chemotherapy I was supposed to go on and do radiation treatments.

“During this time period, I had developed an infection with the expander they put in, so I had to have replacement surgery during the midst of this different timeframe between chemo and radiation. They had to remove the expander and place another one in there. The radiation treatments seemed to wear my body down a little bit more than the chemo did.

“There was like 28 rounds of radiation therapy, and at the end of the radiation therapy, I had developed a staph infection on my skin. Radiation tends to burn the skin. I guess it was just too much for my skin to handle at the end, so they ended up having to do what they call a dorsal flap. They had to remove the implant again and take skin from my back and pull it around to cover the burned skin.”

For several years after undergoing chemo and radiation therapy, Brown was either in the hospital undergoing surgery or being treated for infections.

“I was getting tired of being in the hospital,” she said. “After the radiation therapy was done, I went probably another year for follow-ups. Things kept checking out OK. I had some unevenness in my implants that was particularly noticeable to me. I decided to go back to see if they could change that implant up. Prior to doing that, they decided to do what they call fat transfers where they took some fat from my abdomen and some from my thighs and injected it into the tissue in my breast to fill in what was missing.

“Three months later, I had developed some shortness of breath at work and some chest pain one night. I didn’t know if I was having a heart attack. I was having a hard time catching my breath. When I went to work the next day, somebody said, ‘Your lips don’t look normal color. You probably need to get this checked out.’

"Urgent care didn’t want to see me because they said, ‘If you’re having chest pain, you need to go to the hospital.’ I’m a nurse, so you’re just like, ‘Well, do you think this is OK?’ But I went anyway, and my vital signs were OK, but they did a chest X-ray and they showed that I had multiple pulmonary emboli.”

Brown’s doctors thought the multiple pulmonary emboli might have been caused by tamoxifen, a medication she was taking.

“It can cause blood clots to occur,” she said. “I wasn’t sure if it was the tamoxifen or if it was the little multiple injections they did to fill the fat transfer. I agreed to stop the tamoxifen and then they would start me on a different aromatase inhibitor because mine was estrogen positive cancer, which was a good form of the cancer. If I was going to have any kind of breast cancer, at least they could treat mine with removing any possible estrogen from my body.

“During that time, I also had my ovaries removed because that helped to remove some of the estrogen in my body that might feed the cancer. Then they had me on all these medications to help decrease any excess estrogen that was being produced in my body. I took those for a total of five years. They tried a couple of different ones because the estrogen pills put me into menopause. Having the rest of my estrogen removed caused me to have hot flashes and body aches and pains in my knees and ankles … and fatigue.”

Despite her bouts with infections and minor complications, every time Brown went back to the doctor for her annual checkups, the cancer had not returned.

“It was doing well,” she said. “After five years she told me that I was really doing well, but the studies had shown that it’s almost better to take the antiestrogen or cancer pills for 10 years as opposed to five years. I decided at that time that I was probably ready just to stop taking any more pills and lead a more healthy lifestyle — watch what I eat and exercise and continue to live life.

"I felt really good. I just came from a checkup, so this is eight years now and everything’s checked out fine. The only other thing I’m watching is, if you decrease the estrogen in your body, it can also affect the calcium in your bones, so I may have to take some additional calcium for that.”

Asked what helped her to make it through her battle with cancer and the other medical setbacks she was able to overcome, Brown said, “When I got the ultrasound and heard them say, ‘We’re pretty sure this is cancer,’ I was tearful and crying. But aside from that, I have the most wonderful husband and he is so supportive. He never has a pessimistic view on things. If I had a down day, he was there.

“I have a great family too. I have a huge extended family they call ‘the freak show’ because we’re so numerous when we get together. Everybody was so supportive — friends, family, work. If I needed rest, I rested. The girls were very, very supportive as well. I probably couldn’t have done it without the amazing support that I had to keep the positive mind frame — and exercise.”

And after is all said and done, what advice would Brown offer other women concerned about the potential of someday being diagnosed with breast cancer?

“I strongly encourage women to do self-breast exams at home on a monthly basis to see if they find anything different, and to have a mammogram done on a yearly basis,” she said. “Of course, if there’s people in your family history that have had cancer — and I think over the years it’s been more talked about in public and there’s more public awareness — don’t hesitate to bring those things up to your doctor.

“The way they’re treating cancer now is different from when I was going through it. My sister-in-law is going through it right now. They’ve changed some of the medications and it’s hopefully preventing some of the side effects. It’s still very difficult, but just try to keep a positive attitude and utilize your support system.”

Kevin R. Jenkins is the managing editor of the Farmington Press and can be reached at 573-756-8927 or kjenkins@farmingtonpressonline.com

“I strongly encourage people to do self-breast exams at home on a monthly basis to see if they find anything different, and to have a mammogram done on a yearly basis." – Melinda Brown, cancer survivor

Melinda Brown offers advice to women
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