For one scientist, studying cancer suddenly got very personal.
Dr. Kristi Egland's working relationship with breast cancer began long before her personal one: She studied the genetics of breast cancer in her laboratory, as she does today. A molecular biologist originally working on leukemia and lymphoma, Egland realized that the same technologies used to study those cancers could be applied to breast cancer. She made the leap and never looked back.
Her personal relationship with breast cancer began five years ago, when her right breast did not return to its normal size after she finished breastfeeding her son. "Since I study breast cancer in the laboratory," she says, "I had wondered what it would be like to have cancer. Would it hurt? Would I know I had it? Would I be able to feel a lump? I figured that if I did acquire breast cancer, I would detect it early because of my awareness."
In fact, her diagnosis did not come particularly early on. She describes the feeling when she first discovered the swelling: "I felt a deep, empty bit in my stomach. Although I was not in pain or feeling sick, I knew something was terribly wrong. I felt like my body was deceiving me." The appointment with the radiologist after her mammogram was even more sobering. "When I watched the image of my breast with the large tumor mass show up on the screen, life stopped. I was not even sure how I should react to the news that I had breast cancer. Should I cry, be brave or identify other possible causes of the mass? My diagnosis was a triple negative invasive breast cancer with lymph node involvement."
This form of cancer is an aggressive one without targeted therapies. Egland and her doctors opted for double mastectomy, and the days leading up to the surgery were some of the scariest of her life: "I wanted the day of my surgery to come so badly. I wanted the tumor out of my body and in my lab so I could conquer it." Once healed from the surgery, she underwent eight rounds of chemotherapy and 33 radiation treatments.
Egland says that dealing with the fact that she of all people had been affected by breast cancer was not easy in the beginning. "I was 37 years old with no history of breast cancer in my family, yet I was diagnosed. During chemotherapy treatments I used to ask, 'Why me?'"
When Egland first began the treatments, she felt self-conscious about the fact that she was suddenly in this role. "When I was undergoing chemotherapy and radiation treatments, I was embarrassed. I felt like I had the words 'breast cancer' written on my forehead." But as treatment wore on, she began to realize that she didn't get cancer because she'd done something wrong: She got it because her breasts were made of cells - and sometimes cells get mutated. "Cells are not perfect," Egland says, "and sometimes processes go wrong at the molecular level. I like to call it bad luck. If the right combination of mistakes is made in the genome of a cell, the cell becomes cancer. I was not being targeted by God or being punished for some misdeed that I had done in the past. I was the unlucky one in the statistic one in eight women in the U.S. will be diagnosed with breast cancer during her lifetime."
Egland ultimately began to realize that the "why me?" question she had asked in the beginning was not the right one to ask: "At the end of treatment I asked 'why not me?' All women are susceptible. No one is exempt from this disease."
Her relationship with her family - a husband and two young children - has only deepened through her experience with cancer. "I remember lying next to my daughter one night after chemotherapy treatment while she was falling asleep, and her soft, quiet presence curled up next to me gave me the strength to keep fighting and helped me get through the brain-numbing therapy. I would think about the milestones that I would miss if I did not win this battle: graduations, weddings and grandchildren. That thought was the saddest one - the thought of not being there. I realized life would continue without me, and those that I loved would be okay. The aching question of 'is my cancer gone?' would not go away."
In the end, Egland's personal relationship with cancer has helped her own research and her feelings about patient care. She says that as a general practice she would love to see a research scientist being included in the team of experts treating a patient, to help direct and personalize therapies as much as possible. She encourages women to donate both cancerous and healthy breast tissue to research, since both are needed to uncover the mechanisms behind breast cell division, normal and diseased.
Egland now keeps her preserved tumor in her desk, partly to feel the power over it that she had so needed while it was still in her body, and partly for research purposes. "When I was handed my tumor, I finally felt like I had control over my cancer. To this day, I still feel empowered when I take my tumor out of my desk drawer. Also, we know a lot about the tumor, so it comes in handy when we need to optimize a certain test in my lab."
Her battle has also altered her feelings about her own road in life in a larger sense. "I do not worry so much about the future anymore," she says. "After fighting for my life against breast cancer, I feel I can face anything that may fall in my path. I have confidence in myself and in my decisions. I know the meaning of family and true friends... I am a wife, mother, scientist and breast cancer survivor."
Kristi Egland is associate scientist at the Cancer Biology Research Center and assistant professor in the Department of OB/GYN at the University of South Dakota. She is the recipient of a Susan G. Komen for the Cure Career Catalyst grant for this research.