My cancer journey starts in December 2008 – I was living in Italy, but was back in the US visiting my parents and friends with my Italian fiancé for a vacation.  I remember I woke up in the middle of the night with a sharp pain near the rib cage under my right breast and when feeling around I found a small lump that was sensitive.  I immediately panicked, but first had to figure out if I could even get this type of healthcare in Italy, where I was living now for 4 years.  I wasn’t signed up in the health care system, as I was never “sick” and I had done mammograms in the US on previous visits.  The mammogram just one year earlier in the US said everything was all ok, so I was caught a bit off-guard.

We went back to Sardinia and then got my Healthcare sorted, I went to a local gynecologist for a check-up and opinion on the lump.  She referred me to get a mammogram and ultrasound to see what the lump looked like.  I got into the nearby hospital for the Mammogram the next week and after a few of the first images were taken, the doctor asked me if I would mind staying longer and having the ultrasound after he finished the mammogram images as he didn’t like what he was finding.  Of course, I said!  I was then scared.  We did the ultrasound, and I could see the mass (tumor) it looked like a ragged arrowhead triangle like shape with no clean edges ….  I was like – oh, that is not good!  The doctor told me to go immediately to an Oncologist and that in his opinion I would need to have surgery …. Subito (right away!).  He explained that he saw these images every day and this mass did not look good at all.  My fiancés best friend, Fabrizio recommended me to a friend of his from school (from our same small town) who was an Oncologist at the huge teaching hospital in Cagliari, about an hour away from my home and she got me in the next week.  After looking at my exam results and images she immediately scheduled me for a biopsy later that week.  It took 3 days for the results and on Friday the 13th , I got the results -the cancer rodeo started.

DX was carcinoma / Cancer – stage 1.   My Oncologist pulled some strings and got me in for surgery within a few weeks and had a 1/4 mastectomy and 3 lymph nodes taken to check for cancer.  I had clear margins on the tumor, and clear lymph.   But when the actual tumor results came back about 30 days later my Oncologist called me back in and she was very quiet, her face was serious and stark, she looked scared.  She said – you MUST do treatment – pointing to the words on the results paperwork underlining cerb2 and Her2+++.   I was like – no way – I had clear margins, no cancer in the lymph nodes – NO CHEMO!  But she went on to explain that I didn’t understand – the type of cancer found in the tumor was bad news.  Her2+++.  The Her2 itself is bad but the + signs are allocated on the severity of the expression of the Her2 and they come in 1, 2 or 3 “+” marks.  I had 3+++!

Which basically means it is one of the most aggressive types of Breast Cancer and many women do not survive.  My Oncologist Elena knew I was really against any cancer drugs — and didn’t want to do any chemo, but after finding out I had Her2, she was blunt, not mincing any words and said I MUST do chemo to get the Herceptin to save my life.  The catch was the “protocol” for Her2 Breast cancer treatment is that they will not give you the Herceptin without Chemo.

Eleana gave me 3 different levels of chemo I could read up on the drugs in English and then choose.  I read about all the different chemo choices and Navilbine was the only one that didn’t have so many bad side effects (like one chemo option said heart failure and I figured combined with Herceptin – as Herceptin has negative side effects with possible heart damage or heart attack –  it could be a bomb for my heart) and then I found some articles that said that when paired with Herceptin this low dose chemo had the same results as higher more toxic chemo drugs.  After that it was a no brainer for me.  Sadly all the research, overall, scared me nearly half to death, what I kept finding whilst researching Her2+++ was that the overall life expectancy is low.  So, I was very concerned and did more and more research looking for other options to extend my life.  I kept finding that women with Her2 diagnosis have low life expectancy.  So, I took all the advice of my Oncologist and started a year of treatment including chemo, Herceptin and radiation.  Herceptin (*1) is not chemo but was invented specifically to fight Her2 breast cancer with very encouraging results.  I did 18 treatments of Herceptin over the year of therapy.

  • HERCEPTIN is a humanized monoclonal antibody, designed to target and block the function of HER2, a protein produced by a specific gene with cancer-causing potential. The mode of action of HERCEPTIN is unique in that it activates the body’s immune system and suppresses HER2 to target and destroy the tumour. HERCEPTIN has demonstrated unprecedented efficacy in treating both early and advanced (metastatic) HER2-positive breast cancer. Given on its own as monotherapy as well as in combination with or following standard chemotherapy, HERCEPTIN has been shown to improve response rates, disease-free survival and overall survival while maintaining quality of life in women with HER2-positive breast cancer.

One of the most positive points with living in Italy is the medicine and health care!  I have a great hometown general doctor; great Oncologist and the hospital is brand new.  And… best part —-It is all free!!!!   I have a Permission to live in Italy and with this I have free healthcare.  In total, with all my tests, bone scans, radiation, Chemo, Herceptin …. I have spent less than 100 euros up and until 2012.  On top of this, because I was not working, the state reimbursed me for my gas to drive to my appointments and therapy in Cagliari – as I live about 50 minutes to an hour from the hospital.

I also took a healthy approach to fighting cancer …  first I read every book I could get my hands on about cancer and fighting cancer naturally.   I became a vegan.  Ok, I cheated occasionally with a tablespoon of parmesan cheese on the occasional pasta – and did have probably 1 egg a week as I love, love, love eggs!  But I found the transition to being a Vegan simple.  There were so many amazing fresh veggies here (organic) and I didn’t really miss the meat or fish.  The hardest part was trying to explain to the Sardinians that I couldn’t eat meat — at that point in 2009-2010 no one really knew many Vegans here.  I would say – listen it is for my cancer diet – and I just don’t eat anything that every had eyes or a heart.  Pretty easy — no? – see part 1 for books to read.

Then 4 years later, in 2012, I found out that I had cancer again for the second time.  I was working remotely for a software company out of England, and had just broken off my engagement to my fiancé  (note 5 weeks before our wedding) and had gone through a pretty stressful year.  However, when doing regularly scheduled controls and exams – they found something they didn’t like in the right breast that was operated on before.

I was like – hey, I did radiation – it should have sterilized that zone and I did chemo and Herceptin – I’m sure it is just scar tissue. But the doctors pushed back and thought to have more tests – the mammogram showed nothing, the ultrasound — nothing, but the doctor thought he could feel a lump – so he pushed me to have an MRI and / or meet with the surgeon who had done the first surgery.  I met with the surgeon and she wasn’t very positive that it was nothing – she suggested a biopsy to just double check it.  3 days later- results were evidence of cancer cells – but not full-blown cancer diagnosis.  So, I went for an urgent MRI and that immediately showed 2 tumours both over 2 cm on either side of the breast.  They looked like two aliens hanging out in the breast – it was so eery.

However, because at this point, I had become friends with my Oncologist here in Sardinia, Elena, I trusted her when she suggested I go directly to the huge cancer specialist hospital in Milan called IEO Institute of European Oncology.  They only do cancer.  The hospital was founded by a world-renowned Breast cancer surgeon.   I booked in to see his son, the top surgeon for breast cancer at the Institute and regarded throughout Europe as one of the best of the best, the Dr. agreed with my Oncologist in Sardinia that I should have a mastectomy and that they would do the reconstruction in the same surgery.  That is their speciality in Milan – no messing around – get it all out – then rebuild and you wake up intact.  The plan for my surgery was a bit more complicated because I had done radiation – the effects of radiation make it very difficult to rebuild the breast as the skin is so fragile it tends to almost degenerate.  They decided since I was healthy and a non-smoker – they would do a very complicated surgery of a Diep-flap and basically cut out a large portion of the front of my abdomen (to pull the tissue from the skin level down to the stomach wall) from hip to hip and use the tissue and the skin to rebuild the breast and replacing the bottom half of the breast with the skin from the flap, where the skin was damaged from radiation 4 years earlier.

I checked into the mega cancer hospital the day before surgery in February of 2013.  The plastic surgeons came in that evening with a magic marker and made drawings all over my chest – both breasts and my stomach on where they wanted to cut and fill basically.  Surgery ended up being 10 and a half hours.  I woke up in intensive care and was there for 24 hours before getting transferred back to my room and stayed another 6 days before heading back to my island of Sardinia.  The surgery was intense as they had to basically rebuild a DD breast with tissue and then reattach the main blood to the tissue they were transplanting in microscopic surgery on the veins and artery.  They then did a slight reduction of the left breast to make it “match” more or less, the newly built breast and then they had to stretch all the skin back over the flap they cut out and sew me back up from hip to hip.  Thankfully, it was a successful surgery, and I couldn’t believe how good of a job they did.  Yah, it’s not the same – it feels like someone sewed a piece of steak the shape of a breast onto my chest wall (LOL) but is my tissue – not an implant and it changes with time as I might gain or lose weight. There is no reason to believe I would get cancer back here unless it somehow manifested from cells left on the chest wall when the surgery was done.

The tumors were both Her2+++, but margins were clear, the sentinel lymph node they dissected was negative, so they were fairly confident that they got it all.   Then the long road to recovery – and more treatment – and 18 more Herceptin treatments over the next year.

After the mastectomy, and after getting cancer the second time, I was not so sure that my Vegan diet had really helped me (even though the IEO encouraged good nutrition and Vegetarian diets) but I just gave up most of all the restrictions that I had placed on myself over the last 4 years and decided to LIVE.  I chose to eat healthy, mostly vegetable based diet, but splurge when I want – and drink plenty of the local organic red wine that is chocked full of antioxidants!

Fast forward to 2023, I am now 10 years cancer free – and I hope to live a long life.  Honestly, I thank the doctors here in Italy and I owe a few of them my life.  First was my friend Dr. Elena,  who was the one who insisted on me taking the Herceptin treatments and suggested I go the Institute of European Oncology.  The first plastic surgeon at IEO, Dr. Andrea,  who convinced me to this the complicated diep-flap surgery and not to give up.  Dr. Paolo, who did the excellent mastectomy and Dr. Christina, the plastic surgeon who orchestrated rebuilding my entire chest.  Most of all I am thankful for the excellent care I received, and it all was done for virtually no cost out of my pocket.  Amazing!

I think that every cancer survivor will probably say the same thing, that you never really get over the trauma of that “C” word diagnosis – I think we all stress out with every follow-up control exam, and you wonder anytime you get a strange lagging pain – you panic a little inside and think – is the cancer back?!  I believe that you need to stay positive and be aware of your body and how you feel.  Keep an eye out for anything that might be out of the normal and make sure you stay under your Oncologist’s care.  Thankfully, after 10 years, I hope I can say I am out of the danger zone.

I just turned 59 – which at the time of my first cancer diagnosis in 2009 at age 44, I would have never dreamed I would see 50 – little lone 59!   Life is good.  I try to eat healthy, organic (when at all possible), I take supplements (but not obsessed with them like I was at first), I drink lots of water, I get plenty of good Vitamin D from the sun, exercise and swim in the sea.  Sun and saltwater therapy are the best!

Submitted by Karen Wheelhouse