Silver Linings Playbook
“I’m extremely lucky.”
Those aren’t the words you typically expect from someone battling breast cancer. But Toni White focuses on the silver lining despite some dark days.
White already had a lot on her plate in late 2013—a full-time job with Cedar Rapids schools, a full household (husband, three children and one grandchild all under one roof), and a sister dying of lung cancer. When White noticed a lump while taking a shower, she initially tried to ignore it, but admits, “I knew it was different.” Once she called her doctor, Toni quickly found herself in a whirlwind of mammograms, an ultrasound and a biopsy.
Mona Cook, breast cancer care coordinator, was at White’s side from the initial mammogram. It was Cook who told White that her tumor was malignant. “God bless her,” says White. “Mona walked me through the steps so I knew what to expect. She introduced me to the doctors and the rest of my care team, explained what was going on and answered my questions.”
Initial testing revealed Toni White had triple negative breast cancer (TNBC). TNBC accounts for just 15 to 20 percent of all breast cancers in the U.S. White’s oncologist, Rasa Buntinas, MD, Physicians’ Clinic of Iowa, explains that “triple negative” means the cancer does not respond to three common hormone blockers, making it more challenging to treat. Typical breast cancer protocol is surgery followed by chemotherapy and/or radiation treatment. But with many TNBC, aggressive chemotherapy is done prior to surgery.
White chose to first go to Florida for a final visit with her sister, saying “I’m a firm believer that my life doesn’t have to stop because I have cancer.” She then returned to Iowa and had her first chemo treatment on her 45th birthday. White quickly found that trying to run a busy household and manage her job while undergoing chemotherapy was too much. “Cancer is more than just a diagnosis,” says White. “It impacts your whole life.” Eventually she had to give up work to focus on fighting her disease.
“Fortunately I had a great support system,” says White. “I have a group of friends who went to chemo with me. We’d hang out, laugh, and when it was over, we celebrated with a big party.”
After six months of chemotherapy, follow-up scans indicated the chemo eliminated all of the cancer. That’s where the lucky part comes in. White says she had the advantage of going into surgery knowing the cancer was gone. It gave her more time to consider options and make the best choice for her.
Breast Cancer and Decisions
“Breast cancer patients have more decisions to make than patients with other cancers,” explains Cook. “Depending on the circumstances, the cancer surgery can range from a lumpectomy to a double mastectomy. Then there’s reconstructive surgery, and that offers several options as well.”
Cook says some women know exactly what they want from the start, but others are overwhelmed by all the choices. Count Toni White among the latter. She especially struggled with the options for reconstructive surgery. White met with Physicians’ Clinic of Iowa surgeons, Kerri Nowell and Kahlil Andrews. She also talked to other patients and even called the Mayo Clinic. White says she trusted her care team, finding them knowledgeable and experienced. Above all, she appreciated the support she received from Mona Cook.
“Mona was my go-to person,” White says. “I’d call her bawling and she’d calm me down. She also made sure that I, my husband and children were all well informed.”
Eventually White made her decision. She had a double mastectomy in July 2014 with Dr. Nowell and implant surgery in December 2014 with Dr. Andrews. “I was so glad I wrapped this up in a year,” says White. “I intend to erase 2014 from my calendar, so I can get back to work and to a normal life.”
As part of that, White has taken advantage of resources available through the Community Cancer Center. She worked with dietitian Beth Beckett to find healthy, easy to prepare meals. Exercise specialist Matt Schmitz became her personal trainer and helps her focus on wellness. White also used the Community Cancer Center’s counseling services and integrative wellness services to help her feel good about herself. She plans to continue using the services moving forward.
“My disease has given me a new sense of priorities,” says White. “I’ve learned to focus on what’s important and what isn’t. My goal for the future is to do what makes me happy.”