Cindy Gwynn,
a survivor of triple-negative breast cancer
Hope is a powerful force. And when it comes to fighting breast cancer, it's just the beginning.
Cindy Gwynn, a survivor of triple-negative breast cancer, believes hope was a driving force of her beating the disease - but she also knows there was a lot more to it.
Cindy was 48 years old when she was diagnosed with one of the most aggressive forms of breast cancer. While remaining positive was important, her loving family, supportive colleagues and students, and care team at Chester County Hospital were just as critical.
What Is Triple-Negative Breast Cancer?
Most breast cancers are fueled by three main receptors - estrogen hormone, progesterone hormone, and human epidermal growth factor (HER2) protein.
Triple-negative breast cancer, however, tests negative for all three of these receptors. Because it isn't fueled by hormones, hormonal therapy medicines and medicines that target HER2 aren't likely to stop the spread of this form of cancer. As a result, it often requires more aggressive treatment.
Shifting Priorities
Cindy was used to a life centered around raising her two high schoolers and teaching 4th and 5th-grade students in special education. But her diagnosis of triple-negative breast cancer meant her focus needed to shift to her own health - and how to beat this aggressive form of breast cancer.
Despite a potentially devastating diagnosis, Cindy maintained hope from treatment to an ongoing clinical trial to survival.
"I Found A Lump - And Chester County Hospital Took Me Seriously"
Cindy and her husband James during a recent visit to Ireland
Cindy's breast cancer story began in the Spring of 2018, when her mind was consumed with her children, her husband, and her students - anything but a diagnosis of a serious illness.
"It was a really busy time of year. My husband and I were going away on vacation, my son was graduating from high school, my niece was getting married, and I was hosting my son's graduation party," Cindy says. Amidst the chaos, Cindy found a lump in her left breast while at home one day.
She recalls trying not to jump to conclusions - she knew she had her annual mammogram coming up in a few months. Still, she couldn't shake the feeling that something wasn't right.
When the time for her mammogram came, Cindy informed her physicians at Chester County Hospital about her lump. Her care team reacted swiftly, and they performed an ultrasound and an additional mammogram that same day.
Read more about scheduling your annual mammogram at Chester County Hospital.
"Chester County Hospital took me seriously. They wanted to make sure to give me peace of mind right away," Cindy says.
On August 1, Cindy's radiologist told her that there was an 80% chance she had cancer. A few days later, a biopsy confirmed her diagnosis of triple-negative breast cancer.
"I felt a whole flood of emotions. It's almost like white noise in your head - you don't know who to turn to or where to go first," Cindy says.
Amidst the noise - and just one hour after her diagnosis - she got a phone call from her nurse navigator,
Cynthia Brown.
"Cynthia reassured me that even though this wasn't the best news when it comes to breast cancer, I could beat this and I could survive this," Cindy recalls. "She was the first person to say to me - let's get to work to survive this."
Cindy knew she wasn't fighting for just herself - she was fighting for her family, too.
Her son was days away from leaving for the University of South Carolina, and her daughter was entering her junior year - one of her most important years of high school. She was determined to be there to witness the important stages of her children's lives, and she wasn't going to let cancer take those opportunities away from her.
How Genetic Testing Determined Cindy's Treatment Options
Dr. Susan Chang, MD,
Fellowship-Trained Breast Surgeon
Triple-negative breast cancer can be complex to treat, but Cindy's care team was ready to walk her through the journey, one step at a time.
Dr. Susan Chang MD, Clinical Associate of Surgery, was the first physician to explain to Cindy and her husband the full meaning of her diagnosis and her treatment options.
First, Dr. Chang recommended Cindy undergo genetic testing to see if she was a carrier of gene mutations associated with an increased risk of breast cancer. Sometimes genetic tests are done to determine a person's risk of cancer in the future. However, in Cindy's case, genetic testing would give her and her care team a better understanding of what treatments would be the most effective.
As for surgical treatment, Cindy had two primary options - a lumpectomy (removal of the tumor) or a mastectomy (the removal of the breast). In most cases, either option would lead to similar survivability.
However, Cindy was not most cases.
Cindy's genetic test revealed that she is a
BRCA1 mutation carrier. This means her risk of breast cancer coming back after treatment would be higher - and her treatment would need to be strong enough to prevent that from happening.
Cindy's two options quickly became one. "Finding out I was a
BRCA1 carrier made having a double mastectomy a no brainer. I didn't want to have to walk that journey again if I was able to beat the cancer," Cindy says.
In addition to more intensive surgery, Cindy would need
chemotherapy before her surgery - called neoadjuvant chemotherapy. The goal was to shrink the tumor as much as possible before surgery and make sure no cancer cells are left in her body after the procedure.
"At first, I was ready to dive into surgery. My thought was, 'get this cancer out of me now,'" she recalls. However, after thorough research on her end and a strong amount of trust in her care team, she began chemotherapy.
Chemotherapy, Surgery, and Remission
Cindy recalls everything moving quickly after that. Less than a month after her diagnosis, she began a 3-month regimen of neoadjuvant chemotherapy. On October 15, 2018, she received the news she was hoping for: An MRI revealed that there was no longer evidence of cancer in her body.
Dr. Meher Burki, MD,
Hematology, Medical Oncology
Her oncologist, Dr. Meher Burki, MD, called Cindy on her personal time at 7 PM that evening to tell her the good news, which came just months before the holidays. Instead of worrying about the future, Cindy was able to celebrate with her family and loved ones.
Cindy says she felt incredibly comforted by the care and empathy that Dr. Burki and her team, including Mary Zimny, MS, CRNP, provided throughout treatment. "They are healers in an emotional environment, and their spirit and positive care inspires the fight against cancer," she says.
Still, her battle with cancer was not over. Triple-negative breast cancer is tough - and her treatment needed to be, too. Because BRCA1 carriers have a higher risk of recurrence, surgery remained an important step of Cindy's battle against breast cancer. She continued chemotherapy through January, and in February, she was finally ready for surgery.
On February 8, 2019, Cindy had a double mastectomy. When she walked out of the hospital, all signs of cancer in her body were gone, and she was officially in remission.
Cindy says she knows science - and hope - made beating this disease possible. "Science has come such a long way. There is so much they can do for women who have been diagnosed with breast cancer and those with a family history. And there is so much hope out there," Cindy says.
A Journey Not Yet Over
Cindy was itching to return to the classroom, and by April, she was able to do just that. Even though she was able to finish the school year with her students, she missed out on some valuable class time with them.
One little boy that she had known since kindergarten was heading off to 6th grade at the end of the year. "He told me he wished he could roll the clock back two weeks to spend more time with me," she says. "And then he asked if I could come with him to 6th grade."
In the classroom, things were getting back to normal for Cindy. But her journey with breast cancer was not over.
Cindy was a candidate for a screening study at the Abramson Cancer Center at the University of Pennsylvania called SURMOUNT, which tests women who've completed breast cancer treatment for cells called Disseminated Tumor Cells (DTC). DTC cells are hibernating cells in the bone marrow that can be an indication of a possible recurrence of breast cancer.
When Cindy's bone marrow tested positive for DTC cells, she became eligible for a clinical trial called CLEVER that uses targeted therapies to get rid of those cells, which she enrolled in right away. "Learning about these DTC cells wasn't comforting," Cindy recalls. "But it was good to know that I was doing something about it."
As of September 2019, she's still in the early stages of the trial, but she has hope. The trial offers a feasible, safe, and tolerable option for women like Cindy, potentially preventing their cancer from returning.
"While it was a setback to learn I was carrying these DTC cells, these are all preventative measures," Cindy says. "Maybe it's because I'm in education - but that knowledge is truly power for me," she says.
Three weeks after her mastectomy, Cindy (second to the left), attended an event
supporting the Triple Negative Breast Cancer Foundation
Backed by a Team of Unsung Heroes
There's no question that Cindy had plenty of support throughout her treatment, including her family, fellow teachers, and friends.
Cindy says that her husband, for example, was "her rock" throughout treatment. "He was a steady voice of reason. I tend to be very optimistic, positive, and level-headed - but it's hard to be that way when it's you that's in crisis," Cindy says.
As for her care team at Chester County Hospital, she says they're "unsung heroes."
"The doctors and the nurses gave me encouragement the entire way. They validated my questions, they spent time with me, and they encouraged me that I wasn't just a number or a patient - they truly cared about me," Cindy says.
When she thinks about all the time she's spent battling breast cancer, she knows that her support system was right up there with the importance of remaining hopeful.
"Support is important in your journey to battling and healing," Cindy says. "You have to look at your health as a holistic approach. It's not just the medicine or the treatments - it has to be your mental attitude and the people that you surround yourself with that lift you up and support you."
Do you have questions about treatment for triple-negative breast cancer? Call 800-789-7366 to make an appointment at the Abramson Cancer Center.
Read about clinical trials at the Abramson Cancer Center at Chester County Hospital.
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