13 minute read
Survivors Giving Back
Meet Jeanne
Amy Litterini: Jeanne Davidson was my first physical therapist (PT) mentor as a new graduate in 1994. We have been dear friends ever since, and along the way she became a breast cancer survivor. In 2022, she became a volunteer model and advocate for our survivorship education at MaineHealth, and we sat down recently to capture her story.
Jeanne: I had a long, happy career as a practicing PT for 40 years, and recently retired. I loved PT since I was a high school junior, and I knew that was going to be my career. Orthopedics was a special love of mine, so I after I got my BS degree, I attended an orthopedic residency program in manual therapy. I then taught in that program, as well as specialized in treating patients with spinal diagnoses. I later earned my DPT in 2005 from Mass General Hospital. My last job was at York Hospital in York, Maine, and I was there for 25 years as a senior therapist. It was a wonderful opportunity to be able to treat patients, develop programs, mentor staff and PT students, and to get to know the community on a whole different level.
I got diagnosed with invasive ductal carcinoma of the breast when I was 46 in July 2004. When I got the diagnosis, I just was stunned saying, “Oh my God, I've got cancer. That little lump was bad.” I was very fortunate to have it be a small lesion, 1.3 centimeters. It was Grade 1, and my prognosis looked good that there would likely not be lymph node involvement. My whole overview was that it was a piece of tissue that went bad, and I was glad that it wasn't a piece of tissue that carried a big function. I'm a physical therapist. I value health and I value function, and I looked at this lesion as being in a piece of tissue that was not vital. It was not a vital organ…to me, it was just gland tissue. I just needed to get rid of this diseased tissue. That was my thought, and I wanted to get back in the game of life of being happy, healthy, functional, and doing all the things I enjoyed. So in working with my doctors, the treatment options given to me were the standard of care at that time (and still are), surgery as the first-line. The first option was lumpectomy with a wedge resection and then followed up with radiation. My goal was to do a treatment that was definitive and get me back in my game as quickly as I can. A second option, although not as common for my small lesion, was a mastectomy. It would avoid the need for radiation as long as the chest wall tissue came back negative, and as long as there would be no lymph node invasion. So I knew if I chose a mastectomy, I would have definitively gotten rid of the tissue that went bad, and I could be done with my journey. I could eliminate the radiation, have a quicker rehab, and thank God that I could get out of these dark woods quickly. The third option would have been mastectomy with reconstruction to replace the breast and make me “whole” again. My first thought was having an artificial breast put back on me does not make me whole, so that was not something that appealed to me. Knowing other friends and patients who went through journeys with reconstruction at that time, I knew it involved going through a process of having expanders and injections to stretch the tissue and then you go through surgery to place the implant, then you have to go through rehab. And I just knew, “no thank you”. This was not a road for me. I wanted the mastectomy, and that was my choice, and my loving husband of 16 years fully supported my decision. So, I had my surgery on June 9, 2004, a left modified radical mastectomy with sentinel node biopsy. When I awoke in the recovery room, the first question I asked my husband was if the lymph nodes were negative, and he told me “yes, everything was good”. That's when I said this is a 10K race, not a marathon, because I knew I was blessed to be out of the woods, to not need to go onto a chemotherapy journey. Postoperatively, I healed, and I went through PT with one of my colleagues at York Hospital. I had so much love and support from my family, neighbors, friends, and co-workers at the hospital throughout my journey. And, I have to give a big shout out to Amy Litterini because she has been with me on this journey not only as a friend, but working in the field of oncology she was a great support and also had great resources for me in making my decisions and getting second opinions. I went to Dana Farber, where my history and tumor pathology data were reviewed. My lesion was ER (estrogen receptor)/PR (progesterone receptor) positive, and HER2 negative. This combination carried a good prognosis. In addition to the mastectomy, a bilateral oophorectomy (removal of the ovaries) was recommended to shut down the biggest supply of estrogen in the body, followed up with the medication tamoxifen for five years. With this approach, the likelihood of recurrence was 6% in my lifetime, so I was really happy with my choice. In July of that year, while I was still off recovering from my mastectomy and letting tissues heal, I had a bilateral oophorectomy, which went well. I was back to work right after Labor Day. I felt I was one very blessed woman to have had a short, three-month journey, and a very good outcome for the future.
My family history was that my mom is one of six daughters. My mom had breast cancer when she was 68, my Aunt Mary had breast cancer when she was 73, my Aunt Martine had breast cancer at 70. My dad's only sister, Aunt Gingie, was diagnosed with breast cancer at 68 and died of metastatic disease. Then in December, 2004, my older sister Rindy (a nurse) got diagnosed with a small, lymph node negative breast cancer lesion at age 50. With our family history, a bilateral mastectomy was recommended, and she also went through genetic testing for the BRCA 1-2 genes and both came back negative. Her oncology team at Yale recommended that I reconnect with my genetic counselor to reconsider the risk of recurrence in my non-operated, healthy right breast. With two opinions from Dana Farber and Exeter Hospital, I was subsequently given a 60% chance for risk of recurrence in my lifetime of being diagnosed with a lesion in my right breast. I was given two choices of treatment. The standard of care recommended was surveillance: in six months have a mammogram, the other six months have a breast MRI. So two times a year I would be monitored for life to surveillance in case any tissue became cancerous. Or, have a prophylactic right mastectomy. Again, it’s all about function for me, and about a definitive solution to the problem. So, I opted for surgery. After a denial from the insurance company followed by letters of support, in December, 2005, I had a breast MRI to ensure there was no disease, then I had my right breast removed.
From June 2004 – December 2005, I was happy with wearing a bra that had a little pocket for either a foam or a silicone “falsy” prosthetic. I was symmetrically matched to my right breast. And it didn't bother me at all to just put the left falsy in my bra every day. Then in December 2005, when I had that second mastectomy I became completely symmetrical and flat. I loved the freedom of either wearing a bra or not wearing a bra. I don’t use two falsies; I just wear a standard brand bra that has pre-formed cups if I want to wear an outfit that augments the chest. I love being flat! I love being symmetrical! So, when I look back all these years, I’m so glad to have opted for having the second mastectomy done. It provided me with symmetry, with the freedom of being flat, and with the option of wearing a bra with cups. I am happy to this day with my decisions, and I have no regrets.
In May, 2015, my youngest sister Monica was diagnosed with a more aggressive breast cancer at age 50, which required treatment with surgery (resection and bilateral reduction), chemotherapy, and radiation. She's doing well now.
The one other thought that I have on being a PT, and on valuing function, is that I wanted to be able to support any woman who’s making a decision and finds herself in these dark woods. I’ve met with women who are thinking about mastectomy, and I showed them what a mastectomy looks like and what a mastectomy bra and breast falsy looks like. I'm also glad to have been able to show a double mastectomy because it helped a couple of women make their decisions for it, or against it. It helped some women to know that they would like to have reconstruction. As you go about making your decisions, just know there's plenty of options out there. It's a very individual and personal matter. You need to do what works for you, and your health of having the best prognosis.
Amy: Body image can be a significant issue in cancer survivorship. Can you describe your attitude about body image and how your relationship with yourself before and after your surgery impacted your decision-making process? Do you mind sharing more about that?
Jeanne: I can think of three things from my younger years that have contributed to my body image. First, my sister Rindy and I chuckle about this because our mom, who was also a nurse, was an influence on our thinking of body image as little kids. We could remember Rindy saying, “I don't like my freckles”. And my mother would say, “be lucky that you have good, healthy skin. There are kids that have had burns and don't have normal skin”. Or I remember commenting, “Mom, I don't like the big bulging veins in my leg”. She would say, “be lucky that you have good working legs, some kids don't have legs that allow them to walk or run”. She may have given us dramatic, overboard responses, but her message was true: we needed to be grateful for being alive and healthy and not to put emphasis on superficial looks about our bodies. I feel very lucky to have had her influence regarding body image. Second, I never had big breasts in the first place. My breasts were an A plus cup. When I read the pathology report from my removed left (cancerous) breast tissue, I looked at the weight. My little breast weighed only 9 ounces! This finding gave me more confirmation in my choice to forego reconstruction. I would have had to undergo a bigger, longer journey to replace that 9 oz of tissue! Again, no thank you. And, the third and last thing may sound silly to some folks: I never liked to play with Barbie dolls growing up, which carried a big influence on body shape and image for little girls. Instead, I loved playing with troll dolls, with their smiling little faces, big set eyes, and colorful upright hair… and they have flat chests! I loved them, and I have a collection of them I can’t help but think that those troll dolls played some role in my relationship about body image.
Amy: I know you say yes to me for things because we're friends, but I asked you to do several things now for our survivors, and even mastectomy scar massage pictures, right? You've done it all…you've done a lot for our program. You've done three long patient education handouts for us, the post-op breast exercises, the scar massage instructions, and the head and neck exercises. So having done all of those favors for your old friend, what does it mean to you to be able to do that? I mean, I appreciate you saying yes to me when you didn't have to, but…
Jeanne: Amy, it gives me a very satisfying feeling to be able to give something of myself and my journey that can impact other patients who are facing a similar situation of being diagnosed with breast cancer. Whether they are beginning their journey, on their journey, recovering from a journey and in the rehab phase, I want each survivor to get the best outcome they can. And if my own cancer story, or my participation in the making post op rehab handouts can help one other survivor on their journey, I am grateful for that. Knowledge is Power; sharing my knowledge to empower a patient on their journey and recovery is fulfilling to me.
Amy: Knowledge is power and I couldn't have picked a better individual from the perspective of your personal history and your cancer journey, but also your extensive professional expertise in promoting the exercise component, so I am so thankful to you for doing this for me. This interview is now one more thing that you're doing!
Jeanne: I am more than happy to give any of my time, effort, knowledge, and personal history to help better the lives of a person undergoing cancer treatment. I also want to mention my husband Bob, who helped in my decision making He values health and was in full support of minimally invasive procedures. He was with me on this journey all the way. He knew the treatment options were my decision to make. He loves me whether I have breasts or not. I also need to mention one last thing. I am a faith-based person and I believe in a loving God who is watching over us and beside us throughout our life’s journey. I believe in the power of prayer, and I am grateful to all those people who were praying for me and with me during my cancer journey. I am grateful for the positive outcome that I achieved.
