Sysmex South Africa

Nanette’s story: the power of a strong support system

It all started in 2016 when Nanette felt a swollen gland under her right arm. At first she thought it could be attributed to a cold she was fighting, but the lump remained and she realised it’s a good idea to have it assessed.

Before heading to a clinic, Nanette consulted a doctor friend of hers for advice. This friend insisted that she listen to her gut feeling and advocate for a biopsy straight away. Luckily her doctor at the time respected her wishes and performed a biopsy, with the results confirming that she indeed had cancer. The type HER2-positive breast cancer, which means that there is a specific protein present that promotes the growth of cancer cells.

Following all of Nanette’s subsequent diagnostic tests and scans, some regional metastasis was found in some of the lymph nodes in the clavicle area and some parts under her arm, however no organ or bones metastasis was found. At this point is when it really started setting in for her. She describes having a ‘quick, one-minute freak out cry, ugly cry’ with her husband and then dusting herself off to get ready for the coming changes.

I immediately had a sense of readiness to battle.

Treatment and surgeries

Before Nanette’s treatment and surgery journey began, she had some worries about broaching the topic with her daughter, who was five years old at the time. She spoke with one of her doctor’s about how to introduce the topic to her so that she wouldn’t be scared and would understand. The doctor recommended bringing Nanette’s daughter along during her next appointment, and there she would explain the topic with some toys and dolls. The doctor told her daughter that mummy is going to get sick, and because of that there might be some hair loss and some other things that mummy can’t do, but she will get medicine and eventually get better and be the old mummy she knew again.

When it came time for treatment, which started very soon after diagnosis, Nanette asserts that the treatment and its side effects weren’t too bad, but of course they weren’t a walk in the park either. She first started with chemotherapy for the first six months, which left her extremely tired and with a bit of nausea, which she likened to a bad case of morning sickness. After those first six months, she began a one-year treatment regimen of Herceptin (also known as trastuzumab) once every three weeks. This drug is an antibody used to treat breast cancer (and stomach cancer) that is specifically HER2-positive. The symptoms associated with Herceptin treatment are not as harsh as with active chemotherapy, but they are still present and have a negative impact on daily life, Nanette explained.

Following the chemotherapy and Herceptin treatment to control the growth of the cancer, Nanette had to undergo a mastectomy on one side with a latissimus dorsi flap. A latissimus dorsi flap allows for a smoother breast reconstruction, in that an oval flap of skin, fat, muscle and blood vessels from the upper back is used to rebuild the breast.

Side effect turned symbol of strength

One of the biggest hurdles Nanette had to come to terms with was the hair loss. Not only did she think of the hair on her head as a crown and a symbol of who she was, she was also nervous about losing parts like eyelashes, as she loves wearing mascara. She was informed that about two weeks after the first chemo treatment, hair would start falling out. In order to finally come to terms with it and take control of the situation, Nanette was at a friend’s house one day and made a quick decision. She called her husband and said, “On your way home from work, you need to stop at the house and pick up all of the shavers we have and come here [to the friend’s house]. We’re doing this here.” After a bit of nervousness and procrastination, Nanette’s daughter pulled up her sleeves and said, “Ok mummy, let’s be brave.” She then grabbed the shaver and took the first bit of hair off, leaving the adults in the room quite surprised. Nanette reassured everyone and encouraged her daughter to keep going. Then, they all took a turn – Nanette, her husband and daughter, her friend and her friend’s children – and cut off a bit of hair. Taking ownership of this moment together with her amazing support system is what got her through it.

During this part of the journey when her hair was gone, Nanette threw away the notion that she absolutely needed to wear a wig. It was itchy and scratchy, and just did not give her the joy she thought it would. So she proceeded to live her life normally and go out with her shaved head, and in doing so, received many comments from strangers about she is an inspiration. “And at that point, I couldn’t wear a wig anymore. It felt like I was hiding something that could mean so much to other people, that I just went about my business being bald.” To her, it had morphed into a badge of honour.

I’m coming to the realisation that you don’t know whose life you’re touching in what ways, simply by getting up in the morning and going to the shop to buy milk.

Expect the unexpected?

Nanette had always dealt with fertility issues, even before giving birth to her daughter, so she thought it lucky to have frozen some embryos from earlier on. But due to all of the chemotherapy, radiation and stress of the cancer journey, her oncologist informed her that it was no guarantee that her ovaries could be ‘switched back on’. With the possibility of growing her family not being clear, Nanette’s plan was to finish her treatment and surgeries, then enjoy a relaxing island vacation with her husband. After that, they would think about next steps for having another baby.

But maybe you see it coming already…that plan didn’t exactly work out. Nanette was going to work one day and felt something going on in her stomach area. She felt like it had somehow grown and was sitting in her lap as she was driving. She instructed her husband to pick up a pregnancy test and lo and behold, she had gotten pregnant naturally after fertility problems, chemotherapy, radiations and surgeries!

And out came the positive pregnancy test, so I had fallen pregnant naturally after chemo, radiation surgery, after fertility problems.

What others should know

When asked what kind of message she would share with the public or young people who don’t take the topic of breast cancer so seriously, Nanette stresses that we should educate people on how different and severe each case can be. This is why the right treatment for each patient can look so different, so she says to question everything and make sure to get a second opinion so that you know your specific cancer is being treated effectively – they have to specially design your treatment plan. Take the time to find the right doctor with the right level of information, then arm yourself with education and bravery to get going as soon as possible.

I think because I’ve survived such a severe thing, I have so much less fear in the world. Little things don’t scare me. Losing money, losing something, all of the material stuff, and the ego stuff doesn’t matter. Because I realised at the end of the day, they don’t make us.

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