Prostate Cancer Diagnosis and Staging: Practice Essentials, Overview, Relevant Anatomy

'I Was Diagnosed With Late-Stage Breast Cancer At 28. Six Months Later, It Came For My Sister.'

On March 27, 2024, I was trying to sleep after my night shift as a paramedic when I rolled over in bed and felt a lump in my breast. I wasn't concerned about it, and neither was my primary care physician, who thought it was a fibroadenoma (non-cancerous breast tumor) or just some swelling from hormones.

To be safe, I got an ultrasound. The tech who did my scan called in the radiologist, who looked at the images for a while, which I knew wasn't good. My biopsy the next week confirmed it: I had invasive ductal carcinoma. Breast cancer. Doctors weren't sure how long it had been there, but decided to treat it as Stage III cancer and told me they thought it was curable.

Many doctor's appointments later, my oncologist found that the tumor was bigger than they thought, and that it might have spread to my lymph nodes, sternum, and sacrum. So the plan was to do chemotherapy to shrink it, then a double mastectomy, then radiation. Everything was happening so fast, and it was a lot to digest, but I wanted to start as soon as possible. I knew this medical condition was time-sensitive and didn't want the cancer to spread, plus, I wanted to be proactive and not just sit around.

It's crazy that you can take care of yourself and be healthy and this can still happen. Ironically, the summer after I graduated college in 2019, I ran 4,000 miles across the country from San Francisco to Boston with the Ulman Foundation to raise money for young adults with cancer. Two of the three New York marathons I ran were with the same group. I raised money for young adults with cancer and then suddenly became one.

My sister Elizabeth and me after I finished running my second marathon, which was also in support of young adults affected by cancer.Kate Singletary

My life was a roller coaster after that initial diagnosis.

Not only was I dealing with a major life change, but it directly impacted my family as well. I was tested for genetic mutations after my diagnosis, and they found that I have the CHEK2 gene (one of the gene mutations linked to different types of cancer) from my dad's side. I'm a triplet, and when my sister Elizabeth got checked, they not only found the gene, but also Stage I breast cancer, which is something I never imagined would happen.

It was around mid-September when she received her diagnosis—about half a year after my own, and right after I'd finished my last round of chemo.

She told me the news right when I got home from a walk around the block. I started crying. I didn't want her to have to go through all of this too. But she's faced it with a lot of courage and grace, and told me that she would be much more scared about her diagnosis if she hadn't seen me already go through chemo with a later-stage cancer.

Elizabeth and me taking our first walk after our double mastectomies.Kate Singletary

Part of me keeps wondering what else I could've done to prevent this. I beat myself up for not noticing the lump sooner, but breast cancer can sneak up on you. I had been doing self breast checks every few months because my cousin is a breast surgeon. I shadowed her during college and watched breast exams on patients because I knew I wanted to go into some field of medicine. But I started forgetting to do them because I'm only 28, so I wasn't worried about getting cancer. The last time I checked was the fall of 2023, but I'm not sure if the lump was even there yet because I have dense breast tissue, which makes it hard to feel lumps. But I couldn't help thinking: if I'd used my hands instead of a loofah to wash myself in the shower, I would've felt the lump sooner.

I began 16 rounds of chemotherapy on May 1.

The process was tough—and 20 weeks long. I didn't have much energy and I struggled with anxiety because there were so many unknowns: What if chemo doesn't work? What if the cancer spreads? What if treatment works, but then the cancer comes back? If I'd had the double mastectomy first, I would've at least had some peace of mind knowing the root problem was gone. But instead, the cancer was still present in my body throughout chemo.

One of the few things that could take my mind off these spinning thoughts was my day job—I could still do some work at my desk as a paramedic.

Chemo went well, and as the weeks went by, I could literally feel the lump getting smaller in my breast, like it was melting away. Still, I was experiencing some side effects: I had nausea the week before chemo (probably from stress and a shot that basically puts me into a temporary menopause to protect my ovaries from the chemo, which also gave me hot flashes), I lost weight from anxiety, and I was constantly fatigued. I also started losing my hair 12 days after starting chemo, and that's when it felt real because I actually looked like a cancer patient—it was difficult and my mom and I cried together when she shaved my head. By my last day of treatment on September 11, the tumor and lymph nodes in my armpits had shrunk significantly.

Elizabeth and I had our double mastectomies five days apart.

Hers was on October 3. Mine was on October 8. While I don't want her to go through this, it's been nice to support each other through it and spend time together while we're both living at home again. We're holding onto each other through this, even helping each other empty our drains for fluid that leaves our bodies after surgery.

My results post double-mastectomy look good—the doctors think the spot on my sacrum is now benign, and they did another MRI on me to see if cancerous spots showed up, and the spot on my sternum was gone. They also thought that the cancer in my lymph nodes was gone, which made me feel relieved, thinking I was almost done with this whole process.

I rallied around Elizabeth with our brother Jack after her mastectomy, which was five days before my own surgery.Kate Singletary

Unfortunately, it turns out that there is still cancer in that area, so I'll have to have them removed in another surgery, which makes me feel like I'm back at the beginning of this journey because I'm facing unknowns once again. But at the end of the day, this is just another bump in the road. I felt better once I visited my oncologist and came up with a plan to make sure everything goes as well as possible so the cancer doesn't return. I'll have the lymph nodes removed, then six more weeks of radiation after this.

I'm staying motivated through this knowing that other people have had cancer—and beat it. My dad was also diagnosed with multiple myeloma in 2018, but he's been in remission since 2019. Seeing two of my family members go through cancer treatments—and to have their support now—has made me feel more hopeful.

Some days I still can't believe this is real.

Before surgery, I had no idea how I was going to feel—mentally—once my breasts were removed. I wanted to give myself the freedom to feel all of the emotions and not feel pressure to feel "okay" about it. Seeing Elizabeth be so strong through her surgery really helped me, especially because it showed me what I'd look like after surgery.

The first time I saw my incisions after surgery, I was in shock, and definitely emotional, but I didn't have a breakdown over it. I've looked in the mirror a couple times and thought, Wow, my boobs are gone. But I know this is another step in fighting cancer—I had to take away part of myself to make myself whole again.

I miss working out, but I'm just trying to treat my body with what it needs right now. During my chemo treatment, my oncologist told me to not push myself too hard. One of the first times I tried exercising, I jogged two miles, but my body was so tired, it felt like too much. So now, I just walk anywhere from one to seven miles a day, and occasionally lift some light weights. Eventually, I'll get back to marathon training.

I want women to know that cancer doesn't discriminate based on age.

Do your self breast exams once a month and put a reminder on your phone so you never forget. Make sure to also feel your neck, lymph nodes, armpits, and groin. The more you check yourself, the more familiar you'll become with the feeling of your normal breast tissue, and if something feels different, you can get it checked out. If your work offers free mammograms for all ages, go for it. It's easy to procrastinate these health checks when you're young, but the more you know, the more you can prevent.

My mentality about the future changes so much day to day. Sometimes my anxiety makes me wonder if I'll have a future, and whether my cancer will go away, then come back. What's helped in these moments is to just live my life and treat my body well, knowing that things might happen that are out of my control. Sometimes, when I'm stressed, I take a step back and look at the bigger picture. I'm trying to take things slowly, one day at a time—or one mile at a time, like a marathon.

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Dear Abby: My Estranged Sister Has Been Diagnosed With Cancer And I Want I Reach Out, But I Don't Know How

DEAR ABBY: I'm hoping that you can help me. My sister and I are distanced from each other. We haven't spoken since the passing of our mother three years ago. Today I learned that she has been diagnosed with stage-3 cancer. Of course, this has hit me hard. I want to reach out, but I'm not sure how to go about it. She has blocked me from her social media and won't accept my calls. I need to let her know that I'm here for her. Please advise how to approach this. -- TRYING IN THE MIDWEST

DEAR TRYING: Whatever caused the rift with your sister, it is clearly more serious than "distancing." If you put your thoughts and feelings in a letter to her, it will let her know that you love her, are concerned about her diagnosis and ready to do whatever she will allow you to do to help. That's all you can do. After that, the ball is in her court. I hope it works.

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Dear Abby is written by Abigail Van Buren, also known as Jeanne Phillips, and was founded by her mother, Pauline Phillips. Contact Dear Abby at www.DearAbby.Com or P.O. Box 69440, Los Angeles, CA 90069.

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BBC Have I Got News For You Star Opens Up About Cancer Diagnosis And Divorce

Hannah Fry often hosts Have I Got News For You (stock image) (

Image: BBC/Hat Trick)

British academic Hannah Fry has shone a light on her struggle with cervical cancer, after being diagnosed at just 36 years old. The BBC star, who often hosts Have I Got News for You, faced the disease and a divorce within a very short space of time, describing the ordeal as a 'firebomb' to her life.

Despite being cancer-free for three years, doctors once warned that there is 10% chance of it coming back. If it did, she told The Times, that it would likely be incurable.

"I never wanted to tell people if they should or shouldn't have treatment," she told the publication. "But I do think that when it comes to uncertainty and risk, only you can make the decision about what matters to you."

The 40-year-old was first diagnosed with cervical cancer in 2021 (

Image:

BBC)

Find out about the symptoms you need to watch out for and get health advice with our free health newsletter from the Mirror

The 40-year-old was first diagnosed with cervical cancer in 2021 following a standard smear test. The devastating news then led her to have a radical hysterectomy - a surgical procedure that typically removes the womb, cervix, tissues around the cervix, fallopian tubes and ovaries.

Hannah had a number of lymph nodes removed as a precautionary measure too, which unfortunately gave rise to another condition known as lymphoedema. This long-term health issue generally causes swelling in the body's tissues, according to the NHS.

While it may affect any part of the body, it's especially common in the legs. As a result, Hannah then proceeded to have further surgery, while engaging in Pilates to reduce some of her symptoms.

Hannah had a number of lymph nodes removed as part of her treatment, which unfortunately gave rise to another condition known as lymphoedema. (

Image:

BBC)

Last year, the star also faced another scare as experts discovered an unusual lump. Thankfully, it was revealed to be nothing serious, but Hannah said it was certainly a 'sharp shock'.

She told the publication: "I had got into this habit of not really thinking about it, so that was a really sharp shock." Hannah documented her cancer journey in a 2022 documentary entitled Making Sense of Cancer with Hannah Fry.

You can watch it on BBC iPlayer.

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