7 minute read
Survivors Giving Back
By Amy Litterini
In August of 2014, social worker Melissa Gerrish started her dream job as a clinician working with preschool children with special needs. But, in January of 2015 at age 42, she had a routine screening mammogram which revealed a mass in her left breast. She was recommended immediately for a biopsy, which was done on a Monday. She was then diagnosed with breast cancer on a Thursday. She actually had multiple lesions close to her ribcage, and her pathology showed invasive ductal carcinoma which was triple positive (estrogen receptor positive, progesterone receptor positive, and HER2 positive). Her tumor was at an aggressive stage, IIIB. Following two weeks of multiple doctor's appointments and consultations, she began neoadjuvant (before surgery) chemotherapy to try to shrink the tumors. Looking back on her diagnosis, she recalls that in 2008 she had a breast reduction for what at the time were double D breasts. When she was diagnosed with cancer, her providers told her that had she not had that breast reduction when she did, it would have been very unlikely that they would have been able to find this breast cancer diagnosis in 2015.
She had a venous access device (port) put in her chest for her chemotherapy infusions on February 12th, and by February 20th, she started chemotherapy. Her breast navigator at the time was Helene Langley, who was with her every step of the way. Melissa’s goal was to continue to work.
Melissa's neoadjuvant chemotherapy included six rounds of TCHP: Docetaxol (Taxotere) + Carboplatin (Paraplatin) + Trastuzumab (Herceptin) + Pertuzumab (Perjeta). Since this regimen is so hard on the bone marrow, she also got injections to keep her white blood cell count up Following her neoadjuvant chemotherapy, she underwent bilateral mastectomies and a lymph node dissection (0/4 nodes showed any cancer cells). She was not a candidate for breast reconstruction due to a past medical history of neurofibromatosis (a genetic disorder that can cause issues with skin, nerve and muscle tissue).
Post-surgery, she also had 36 radiation therapy treatments to her chest wall and axilla (underarm), even though her lymph nodes were clear. She then received Herceptin infusions for another year. She had some bothersome “dog ears” (an outward puckering of skin on the outside aspect of a mastectomy scar) surgically removed, and her port removed in the spring of 2016. At that time, a lump in her axilla was also found and needed to be removed. It was ultimately found to be benign. Also in 2016, she developed upper extremity lymphedema (swelling in the arm). She saw an occupational therapist certified in lymphedema treatment to treat her lymphedema, and a physical therapist to treat cording (a rope-like tightness) and decreased range of motion in her shoulder, both at Southern Maine Health Care.
Unfortunately, due to her aggressive treatments, Melissa was unable to work as she had originally intended. Her employer at the time (a non-profit) only had short term disability (which provides 66% of a person’s wages). She had been in contact with them the entire time, but 26 weeks (to the day) coinciding with her short-term disability ending, is when she was notified her position was no longer available. After her second chemotherapy infusion on March 12th, her doctors told her to stop working the 2-3 hours a day she was. Two days later, she was notified that insurance would be canceled effective the end of the next pay cycle. While only making 66% of her income, she could not afford COBRA (Consolidated Omnibus Budget Reconciliation Act; a federal mandate that gives the right to remain enrolled in a group health insurance plan).
Her health insurance had ended the day she went out on short term disability. She had to rely on support systems including My Breast Cancer Support, Jennie, and the Dempsey Center. She ultimately sought out the Maine CDC Breast and Cervical Health Program for help, and received insurance coverage through Maine Care.
When Melissa found out her position was no longer available, she then needed to apply for Social Security Disability Insurance (SSDI). She ultimately got SSDI coverage to help with her living expenses. Though all these challenges, she also had to battle debilitating cancer treatment-related fatigue that she would rate the severity at a 10 out of 10.
Once she was done with her Herceptin infusions, she started Tamoxifen for a year for endocrine therapy (to block the effect of estrogen on any cancer cells). She suffered from joint pain and swelling on the medication, so she was switched to Letrozole. She took Letrozole until she had a sudden and spontaneous uterine hemorrhage when out of town for a wedding. Two weeks later, she had a total abdominal hysterectomy (removal of the uterus) and a bilateral salpingo-oophorectomy (removal of the fallopian tubes and ovaries) at age 45. A poorly timed severe migraine landed her in the emergency room three days later where they thought she might have a brain tumor. Thankfully, all testing was negative. She has also had to have multiple follow-ups for what are suspected to potentially be lung metastases; but so far, they have proven to be stable.
In 2019, she was working again as a clinician in a mental health crisis center. Then in 2021, she ultimately switched to become an Inpatient Medical Unit social worker for Southern Maine Healthcare.
Melissa now volunteers for an oncology breast cancer peer support group as the facilitator, a group that she once was a participant in. She is not in a leadership role for the group, but is rather the facilitator of the conversations. Throughout COVID, there were no groups in person, so the program switched to Zoom. When it resumed again in person, Melissa offered to be the facilitator at the Weber building. She's very transparent about her role, and does not wear a clinical hat. She's not there to be a therapist; she's there to be a peer. But, she has the perfect mindset and personal lens for the group. She has also facilitated an expressive arts class for survivors making string art, which was featured in an earlier edition of Thrive.
Melissa has enjoyed participating in the Betty J Borry Breast Cancer Retreats in New Hampshire over the years, and now she has been asked to be a peer facilitator at the spring retreats.
Melissa and her roommate Missy have two cats they absolutely adore: Blaze, a year and a half old boy, and a girl, Greycee Lou, who is a year old. The roommates also have a red eared slider named Collins. Melissa enjoys traveling with her best friends Missy and Jess, a wide variety of arts and crafts, and 80’s TV shows.
Her advice to other cancer survivors is to: “be willing to not only ask for, but then also accept help from others. It means as much to them as it does to you to allow them to help you. So don't hesitate to ask and accept- give yourself that kindness.”
