With a family history of ovarian cancer, Janice Fletcher has always paid close attention to changes in her body. So, when she felt a lump in her left breast in the summer of 2018, she knew something was off and made an appointment for breast imaging at Rush. A mammogram, ultrasound and biopsy later, she was diagnosed with breast cancer. And that began the next two-plus years of Janice’s tumultuous cancer journey.
A team in her corner
After her diagnosis, Janice met with the breast cancer team at Rush University Medical Center. A team of breast cancer specialists — including medical oncologist Ruta Rao, MD, breast surgeon Andrea Madrigrano, MD, plastic and reconstructive surgeon Deana Shenaq, MD — developed a care plan tailored specifically to her unique case and preferences.
From the first day, Janice recognized the compassion and expertise of the breast team at Rush.
“I looked at other hospitals, but none of them compared with how I felt the day I first met with my breast cancer team at Rush,” says Janice. “My youngest son came with me for this first visit and he said to me, ‘Mom, those people really care.’ And he was right. The compassion they had for me was amazing. Every time new doctors walked into the room, they acknowledged me and treated me like I was someone. Really, everyone treated me like I was the president of the United States! I knew they would work hard for me.”
Time to treatment
Janice began treatment almost immediately after her diagnosis. “Within a day or two, I came in for my port placement, and I started my initial six rounds of chemo,” she says.
Throughout this time, Janice continued working doing pharmaceutical education and traveling for her job. After she completed chemotherapy, her surgeons met with her to discuss her surgical options. Together, they decided to do a lumpectomy to remove the cancer and axillary lymph node removal to determine if the cancer had spread.
Despite major surgery, Janice felt calm and confident. “They prepared me for every aspect for that surgery, the whole nine yards,” she says. “They referred me to a place where I could get certain bras that I needed, they walked me through the whole surgery, and they explained the recovery process. They answered every question and made sure that I knew what was going on and what to expect.”
After the surgery, Madrigrano explained that while the lumpectomy was successful, Janice would also need radiation therapy to prevent the cancer from returning.
Up until that point, Janice had been able to continue to work and live her life comfortably despite her diagnosis and treatment. But the radiation schedule — daily radiation treatments, Monday through Friday, for six weeks — sent her into a tailspin.
“That’s when the tears came,” she remembers. “I was at my appointment with Dr. Rao and Dr. Madrigrano, and I just broke down. I told them that I couldn’t stop my life for six weeks. I don’t have family around; it’s just me and my youngest son. I had no one to support me. I was crying like a baby. Then Dr. Madrigrano said, ‘Janice, we’re here for you and we have a lot of resources to help you.’ She was hugging me and telling me everything would be OK.”
Janice’s care team quickly brought in the Cancer Center’s social workers to help. They helped Janice go through her bills, fill out her Family and Medical Leave Act (FMLA) paperwork to allow her to take time off work for her medical care, and determine what supports she needed in place to finish her treatment successfully. “They walked me through everything; it was amazing,” says Janice.
One of the top priorities was finding Janice lodging close to the Rush downtown campus because she could not get herself to campus every day for her treatments.
“They connected me with the IMD Guest House. Everything was taken care of, it was beautiful,” says Janice. “I actually forgot that I didn’t have family support because I had so much support from Rush. There was not a moment of time when I had to worry about anything. I had three social workers all working together and with me to make sure I was OK and taken care of. They became my family.”
Things get complicated
As Janice quickly found out, cancer treatment can be taxing. And she began to struggle with side effects from her treatments, including pain, skin damage, dental issues and more. Yet, with each complication, she spoke up and her care team stepped up.
“Each time something new would happen, I would call my Rush team — and they always put me back on the right path. They addressed all my issues and referred me to other specialists when I needed it. They connected me with specialists in pain management and palliative care who helped me manage my pain, and Dr. Rao stayed on top of all of it,” says Janice.
After her radiation treatments, Janice developed lymphedema, a painful swelling and hardening in her breast. Despite working with occupational therapy for manual lymphatic drainage, wearing a compression bra and working with palliative care for pain management, she wasn’t getting much relief from the pain.
Although her cancer was cured, Janice was in pain and struggling to regain a sense of normalcy in her life. And her team was by her side, letting her know that Rush had the resources and expertise to help her through it. Madrigrano and Rao referred Janice to Shenaq, who specializes in correcting lymphedema surgically.
“When Dr. Shenaq walked in for that first appointment she said, ‘Oh honey, that is really bad,’ and I just started to cry,” remembers Janice. “But she said, ‘I can help you, don’t worry.’”
To relieve the pain, Shenaq recommended a mastectomy with DIEP flap, as well as a lymph node transfer. “They prepared me for every step of the surgery and for the recovery,” says Janice. “After the surgery, the recovery was not bad. My nurses were amazing, and I didn’t have one complaint.”
Most important, the surgery was a success. Not only did it relieve her pain, but her reconstructed breast also allowed her to return to her life with a sense of confidence after such trying time.
Janice is now on the road to recovery and cancer-free. Despite her setbacks, she was comforted by the fact that she had an expert team that never stopped working hard for her.
“Everything that came up, they dealt with – it was amazing,” she says. “I could not have picked a better team. I wouldn’t wish breast cancer on anyone, but if you have to go through this, having the right team on your side is the best you can ever ask for. Especially for someone like me. They were my family. They were my caregivers. They were my support system. And they saved my life."
Janice (center) surrounded by her breast cancer team (left to right) Ruta Rao, MD, Andrea Madrigrano, MD, Deana Shenaq, MD, and Sarah Anzevino, NP.