The summer of 2012 changed Jan Wadsack’s life. Now, more than three years later– after breast cancer, a double mastectomy and arduous reconstruction, thyroid tumors, a year of chemo treatments, infections, frightening genetic test results and even a cancer battle for her dog–she embraces life with a sense of gratitude and a new “after cancer” kind of wisdom, her new normal.
Jan, 48, of Florissant, MO, went for a routine mammogram in July of 2012. Her mammograms often have questionable results that require an ultrasound, and this year was no different. Although there wasn’t anything questionable in the ultrasound, the Nurse Practitioner, Becky Tackett, RN, MSN at Midwest Breast Care told Jan that she was considered high risk, partly because her mother is a breast cancer survivor. After Jan completed a thorough questionnaire, Becky recommended an MRI, as well.
Jan checked, and her medical insurance would only pay a portion of the cost of the MRI, so Jan declined. “I get my mammogram and ultrasound every year, so I wasn’t worried,” she says.
Becky, who had the role of patient advocate, called Jan back told her that she had applied on Jan’s behalf to the Christine Applegate Foundation to get the MRI covered, so Jan agreed to the procedure. Although she attempted to do the MRI, claustrophobia and a problem with the cooling system with the machine combined to cause Jan to interrupt the procedure before it was complete.
“I called Becky and told her I couldn’t do it. She called me back a week later and told me there was a machine at Missouri Baptist that was bigger and more open. She was definitely pushing me,” Jan says. “I know now that by the time my breast cancer would have showed up on a mammogram or ultrasound, it would have been too late for me, so I owe her a huge debt of gratitude.”
Jan’s MRI was at 4 p.m. on a Thursday afternoon. By 7 a.m. the next day, her doctor called to tell her “They found a mass. You need to see a surgeon and have that biopsied right away.”
Less than a week later, Jan got the call from her surgeon, Dr. Diane Radford of Mercy Clinic Breast Surgery and Oncology, that the biopsy showed cancer.
“That’s when I panicked and called my friends,” Jan says.
She had been working with Dr. Mary Klix, an oncologist, over the previous year because she had some blood work that was unusual and Dr. Klix was trying to determine the cause of those results. Jan, Drs. Klix and Radford, Jan’s mother, Barb Lux, and a few trusted friends began to discuss and research treatment options.
“They told me the tumor was a little smaller than a ping pong ball and it was attached to the nipple. A lumpectomy would remove an area about as big as a fist, require radiation and chemotherapy,” Jan says. “And radiated skin is harder for plastic surgeons to deal with. A mastectomy was also going to require chemo.”
Jan decided that since chemotherapy was a piece of both treatment options, she would start with the chemo and take a few months to research and consider her treatment plan. Either way, she was facing four chemo treatments and 20 Herceptin treatments over the course of a year because her cancer was HER-2 positive.
Chemo started on Aug. 30, 2012, and 10 days later, her hair began to fall out. Within weeks, she was shopping for wigs. Not long after that, her longtime-friend and stylist, Kelly Van Pelt, met Jan at her shop after hours and shaved Jan’s head as they both cried. Kelly’s mom had just been through breast cancer as well.
In the meantime, Jan was getting results back from a CT scan that she had prior to starting chemo. That test showed three large tumors on her thyroid attached to her collar bone. A biopsy was done and Dr. Klix met with Jan at her third chemo treatment to tell her the results.
“Up until that point, I was fairly calm – I just knew in my gut that I was going to be fine. I told myself that dying wasn’t an option. But when she told me results on my thyroid were inconclusive and the only way to know for sure they weren’t cancer was to take it out, I finally thought I was going to die and thought the cancer must have been through my whole body,” Jan says.
“I said to her, ‘I’m scared.’ And she said, ‘I’m scared too’. I really lost it then.”
Jan eventually recovered her “fighter” attitude, but her exhaustion from all the chemo treatments and her lack of appetite were starting to wear her down. “One thing you’re supposed to do is stay well-hydrated, but all I wanted to do was sleep. My mom began coming over to wake me every few hours to get me to drink,” she says.
In December, Jan made the difficult decision to have a double mastectomy to reduce her chances of having to go through this treatment again and to ensure a more uniform reconstruction outcome.
“I didn’t want go to through all of this again in five to 10 years. And my surgeon told me that a regular breast and a reconstructed breast never look the same.”
Jan’s surgery was on Dec. 13, 2013, at which point she left work completely because the real work of recovery was about to begin.
Her incision ran from under one arm all the way across her chest and under the other arm with four drains that would remain in for an entire month. A week after surgery, she had a skin infection that required an additional surgery.
One month after her mastectomy, Jan underwent a thyroidectomy. Tests revealed no cancer, but Jan will remain on medicine for the remainder of her life to do the work of her missing thyroid.
Thirty days after her thyroid surgery, Jan had surgery to place expanders behind the muscles in her chest wall to stretch her skin and begin the process of reconstruction. Every two weeks, she would go in and have additional saline added to the expanders.
“I noticed that one side was getting larger than the other and after several x-rays, we found that one of the expanders had ruptured. That was another surgery to get it replaced,” she says.
During her reconstruction process, Jan was dealt another blow. Her beloved companion of eight years at the time, a rescued Labrador Retriever named, Chloe, was diagnosed with bone cancer in her front right leg. “It was like we do everything else together, why not cancer,” Jan says.
The dog required 18 rounds of radiation at Mizzou’s Veterinary Cancer Care Clinic in Wentzville, MO. “I was working (part time) mornings by then and having surgeries every 30 days for reconstruction, and Chloe’s treatments had to take place in the morning, so my mom would drive her every morning from Florissant to Wentzville. It was another area where I just had to surrender and accept help and my mom was there.” Jan says.
Jan completed what was supposed to be her last procedure before her main reconstruction surgery in November 2013. The next month, she attempted to return to work full time at Renaissance Financial because it was the company’s busiest time of year, but she only lasted only three days.
“I broke down. I couldn’t do it,” she says. “I talked to my oncologist and she said she would recommend six months of part-time work. She said I could keep trying to go back and keep crashing, or go part-time and give myself time to heal.”
Jan approached her employer and received nothing but encouragement. “They said, ‘Do what you have to do. Come back when you’re strong enough to come back.’ I can’t say enough about the support.”
Jan’s co-workers also have done fund-raisers for the Christina Applegate Foundation and participated in the Komen walks on her behalf.
For Jan, some of the most difficult aspects of going through breast cancer was giving up control and accepting help. And she says there is no way for her to thank her mom for all that she did. Barb was by her side at the doctor’s appointments, spending hours in the hospital after each procedure, present for chemo treatments, staying with Jan in the weeks following the mastectomy, grocery shopping, running errands, etc.
“I don’t know how I would have done it without her. She would bring me meals, go get my medicine, take care of my dog, everything. She stopped her world for 18 months to help me with mine and she’s amazing. I don’t know how you put words to that. Thank you seems stupid, inadequate.”
Early in the process, Jan underwent genetic testing that determined she was BRCA negative and HER-2 positive. Recently, she underwent additional testing that determined she has the ATM gene (Ataxia-telangiectasia mutated). One characteristic of that gene is breast cancer in women, along with pancreatic and colon cancer.
“There’s not much you can do for pancreatic cancer ahead of time, so this past May, I had a colonoscopy and endoscopic ultrasound on my pancreas and liver to provide baselines.” She will continue to do those tests every three years and see an oncologist every six months as a proactive approach.
Jan is approaching the third anniversary of being cancer free. She’s still not done with surgery because there have been some complications with her implants. Thankfully, she was careful in her choosing of a plastic surgeon, Dr. Keith Brandt, and he told her that they wouldn’t stop until she was happy with the results.
When Dr. Brandt informed her that the harder implants were now approved by the FDA, even though they aren’t made in the United States, Jan had to make a decision about whether she wanted to wait for them and undergo one more surgery.
“I asked him where they were being shipped from, and when he told me Ireland, I almost fell out of my chair,” Jan says. Ireland is her favorite place – she has made seven trips to the country because she loves it so much, and she has shamrock tattoo to prove it.
“I knew these boobs were going to work!’”
Jan says one of the best things she did for herself, besides agreeing to Becky’s advice about the MRI, was to give herself time to carefully consider her treatment plan.
“I’m glad I waited to do my mastectomy because I needed time to really think about it,” she says. “Some women get the diagnosis and make that decision right away. And I hate it when I heard people say ‘why don’t you just get them cut off?’ It’s a hard, major surgery and recovery.”
Jan says she’s also glad she had doctors who worked together to make sure she was getting the best possible care. From her gynecologist, Dr. Mark Jostes, to Drs. Klix, Radford and Brandt, she says each of them were patient with her and were good about sharing information.
“I had a great team – doctors, friends, co-workers and family,” she says. “Life will never be the same, but it’s the new normal. I’ll take it.”
This article originally appeared in New Your Inside and Out Magazine.