the diagnosis: triple-negative breast cancer
Lesson 1: Get the mammogram. Go back when they call you.
Peggy Trepanier has learned a lot of lessons the last few months, beginning with “get the mammogram.” She almost didn’t bother with it, convenient or not. It’s a good thing she did – the breast cancer she didn’t know she had turned out to be triple-negative, an aggressive and fast-growing form of the disease.
With “triple-negative” breast cancer, estrogen and progesterone hormones and HER2 receptors don’t promote the growth of the cancer. This means some of the most common treatments like tamoxifen and Herceptin aren’t effective.
Somewhere between 10-20% of breast cancers fall into this category. Because triple-negative is more aggressive, and some of the most effective treatment options are off the table, it’s important to catch the disease early, be fairly aggressive with treatment, and do everything possible to promote good health.
Peggy’s cancer was very aggressive: at the time of the biopsy, the tumor was 3 x 5 mm. At surgery less than a month later, it had grown to 6 x 4 cm. She was “really lucky,” she says. They caught it early. It hadn’t spread, there was no involvement of the lymph nodes, and they got good, clear margins in the surgery, meaning the surgeons reckoned they got all the cancerous tissue.
But because the cancer was triple-negative, Peggy still had 18 rounds of chemotherapy followed by 4 weeks of radiation to get through.
Lesson 2: Have a secret weapon, like training with Deb.
Peggy’s been working with Deb Haynie, personal trainer and owner of New U Fitness, since the early 2000s (though they can’t quite seem to agree on when), and their long familiarity with the routine makes their sessions look less like training and more like a dance.
A dance that was – slightly – interrupted by cancer.
From diagnosis, through biopsy, surgery, the chemotherapy that finished in January, and the radiation that finished as recently as this March, Peggy kept going, once or twice a week, every week she could.
“During that time, we just went lighter,” Deb says. “We’d do all 15 reps but with lighter weights. She was a real trooper who kept going the whole time. I never heard a negative word. When she lost her hair, she joked about it. I’ll tell you, if I ever have to go through anything like that, I hope I have the same attitude.”
Deb, who is devoted to her clients to the level of half mother hen, half mama bear, did her research to be sure she knew how to guide her client through exercises while Peggy was still recovering. But thanks to that long-term relationship, Deb could also tell when Peggy was reaching her limits.
Even listening to them now, some months later, you can hear the choreography of negotiation and cooperation at work:
Deb: I’m used to having worked with the majority of my clients for so long, I can look at them and tell where they are in the workout. If it’s time to cut it right now, that’s it. Because there were days …
Peggy: There were a couple of days when we just said, “we’re done.” I wasn’t always sure, but Deb was.
Deb: We just did a few things and her complexion was getting a little whiter, so it was time to quit the workout.
Peggy: The only stitches I had were from my lumpectomy, and that was when we just didn’t do a lot of upper body work.
Deb: Fortunately, that was a short period of time because it was such a few stitches. And they wanted her to keep moving because they didn’t want a bunch of scar tissue, either.
Peggy: It was important to keep doing exercise because some people get lymphedema, swollen arm, and they want you to keep exercising so that lymph node is flushing all of those toxins out. Other than just after surgery, I didn’t really have to stop.
Deb: We slowed down sometimes. A little. We didn’t stop.
Lesson 3: Routines can help you survive and heal – physically and emotionally.
Although Peggy is quick to point out that she has nothing to compare it to, she’s pretty sure continuing to exercise made her treatment smoother and her recovery quicker. She was able to maintain some muscle tone and is already nearly back to where she was before in terms of stamina and energy.
Emotionally, working out with Deb was grounding, Peggy says. “It felt like I was doing normal things still, working, exercising. It helped to have that, in between going in for chemo and really not feeling great.” The familiar routine of it, even though the weights were lighter and the repetitions were fewer, gave her a rare chance to feel normal again at a time of enormous uncertainty.
Exercise is great, but you have to do it right, Peggy says. “Some people cannot get up off the couch, they feel horrible. And they shouldn’t feel like they have to just because they hear someone say, ‘Well, I did it.’ Everybody reacts to chemo differently; do as much as you can do and know that the more you can do, the better you’re going to feel.”
Lesson 4: Get a trustworthy trainer – then trust her.
To “do it right,” your trainer needs to be a trustworthy partner, Deb and Peggy tell me. Peggy is, they both agree, getting stronger every day. Deb continues to push her forward but is also a governor to keep Peggy from pushing herself too hard.
Today’s routine was nearly an hour, Peggy moving swiftly between equipment, Deb getting her set up, counting reps and – rarely – correcting Peggy’s form. Occasionally Deb consults a clipboard, but she knows the plan so well, checking the schedule seems almost ceremonial. “Today I went up to 25 pounds [on the weights], to where you were before,” Deb announces after their workout. “But the chest press with the barbell, you’re not quite back. I wouldn’t go up to the 85 yet.”
That willingness to slow Peggy down or stop her if necessary is even more critical than pushing her to get stronger, faster, Peggy says. “You have to have a trainer who can listen and say, ‘this is what she wants, this is how we’ll get her there.’”
“Your goals, not my goals,” Deb agrees.
Peggy’s got a lot going on these days. Her part-time job with a veterinarian’s office has morphed into full time during their busy season, and she’s grateful her energy is coming back. “I get tired maybe every 10 days or so, and I’ll sleep in for a long time, then I’m fine. I don’t do a ton of stuff when I get home after work, but every day is a little better.”
What would she advise others, so they too can have better days?
“Go for your mammograms. Go back when they call you. Don’t wait to get sick to start to exercise; if you can, do it now, so it’ll be there for you if you do get sick. Find a Deb.”
[Read how Joanne dealt with her breast cancer diagnosis and found reasons for hope]
If you’ve struggled with illness like breast cancer, how did you get through it? If you’re still struggling, what’s helping you stay strong?
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