Triumph Over Uncertainty: The Recurrent-Cancer Journey

We all live with uncertainty. But for some cancer patients, uncertainty is chronic – the scans, the possible recurrence, the side effects. For Yolanda Peoples, living with uncertainty has become a “thing”. To cope with recurrent cancer and the possible side effects, she chooses to view herself as a winner – working to make herself well, maximizing her time and rallying around the best team of doctors.

Sitting among plants on the enclosed porch of her Craftsman home in Detroit, Yolanda, 56, writes poetry and reads crime novels. When she’s not exercising, she’s making jewelry or babysitting her toddler grandson. As a vocational rehabilitation counselor, she was trained to make life easier for people with disabilities. Now she has one.

The road less traveled

At age 27, Yolanda was diagnosed with non-Hodgkin’s lymphoma. To treat the neck tumor, she underwent surgery and received chemotherapy and radiation therapy.

Nearly 20 years later, she noticed a blister on her breast. A mammogram showed ominous calcification of nearly all her breast, and a biopsy diagnosed a lump as stage 0 ductal carcinoma. Because of her size, a lumpectomy would greatly change the appearance of her breast. So, Yolanda opted for a TRAM flap – breast reconstruction utilizing abdominal fat, muscle and skin.

“It was instant gratification. I wanted uniformity for my very large breasts. I had no depression, and no grief from a lost body part,” says Yolanda.

Four years later, she was giving a speech to social workers and Yolanda began slurring her words – a massive stroke was occurring. Another four years passed, and a recovered Yolanda was invited to participate in a high-risk breast cancer program at Henry Ford. The program offered two clinical breast exams each year, plus an MRI and a mammogram every six months. The mammogram found another lump.

More complications

During the lumpectomy, a large part of her breast was removed, and plastic surgeon Vigen Darian, M.D. was able to make her remaining breast look normal. But as she was leaving Henry Ford West Bloomfield Hospital, she experienced two mini strokes. Readmitted to the hospital, she learned that her weak heart could not tolerate the stress of the relatively minor procedure and the abdominal wall scar revision.

One month after she finished 15 radiation treatments, she met with her care provider to discuss her weak heart and a possible defibrillator. However, the next day she experienced another major stroke. Emergency responders rushed her to the nearest local hospital.

Trusting Henry Ford

“I was slurring and mumbling, trying to say, ‘I am Henry! Get me out of this hospital!’” recalls Yolanda. Standing nearby, her mother and daughter finally deciphered Yolanda’s words. She wanted to go to Henry Ford.

“The doctor kept trying to give me a plan, but I kept trying to say, ‘No! No! I am Henry ,’” laughs Yolanda, who has received speech therapy since that time. “It helps to have humor.”

Strength from support and compassion

“I come to Henry Ford with expectations, and I’ve not been disappointed too often,” says Yolanda, a Henry Ford patient since her infancy. “I have a team of doctors who make sure we’re all on the same page for my treatment. I’m like a well-oiled machine. They keep my care functioning properly. All my doctors are very compassionate.”

While coping with cancer, Yolanda’s support comes from her extensive family and relatives. Plus, her church friends play a big role in healing and recovery.

Navigating challenges and decisions

Now, Yolanda faces another challenge. “I had the lumpectomy and radiation, and it was supposed to kill all the cancer. But it didn’t happen like that. There are no guarantees,” she says philosophically.

Yolanda’s cancer is not like a tumor or rock that can be easily removed. It spreads through the ducts and tubes in the breast, and it’s not always obvious clinically, says Lindsay Petersen, M.D., who specializes in breast cancer. “Treatments reduce the chance of cancer returning, but it doesn’t eliminate the risk.”

“In order to have peace of mind, I need to get rid of all my breast tissue. I can’t live with this cancer, and these girls are trying to kill me – they have to go!” says Yolanda, softly laughing.

Yet her decisions are full of uncertainty. “After all the breast tissue is removed, I can’t stay on the table long enough to get a breast implant. I might have one flat area and a reconstructed breast on the other side” says Yolanda. “The longer I stay under anesthesia, the higher my risk of not making it through surgery.”

Think. Talk. And Pray.

Some people make decisions based on statistics, life experiences, or the experiences of their friends and family. Others go with their gut feeling. Some people like Yolanda lean on God and prayer. All those factors may come into play, says Dr. Petersen.

“Yolanda is very strong and measured in how she has been weighing her options. She knows her body and asks good questions. She hears the recommendations of her doctors and uses her support system to help decide what’s best for her. Her approach helps doctors become better doctors,” says Dr. Petersen.

Found the cure: purpose and service

In the meantime, Yolanda manages chronic uncertainty by focusing on her family. “When you feel like there’s no hope for the future, you have to dig deep inside and get your purpose,” she says. “Even with these challenges, I’m still of service to people. I fight for public education, and I’m a minister at my church. As long as there’s breath in my body, I’ll be of service to people.

“When people ask me how I cope with this illness, I tell them to focus on your new normal. Don’t live in the past. Set a goal and keep focusing to reach that goal,” says Yolanda who sees a Henry Ford therapist each month for anxiety and depression. “No matter how short your time is, make plans to do something every day that will keep you going. Speak positively, no matter what you’re going through. Take time to be quiet. And do something for someone else, even if you don’t feel like it.”

Prescription from the patient

Most importantly, Yolanda says, “Don’t think of a cancer diagnosis as a death sentence. Go home and cry it out. Tell your family. Then go back and ask, ‘What’s the plan?! How do we get through this?!’ You’ll get the best treatment if you’re part of that treatment. Ask questions. Be honest. Doctors do the best they can with the information we give them. The patient adds to their training to make them good doctors. But understand this – treatment has side effects.”

Says Yolanda, “I’m still alive. I still have a chance to fight and recover. I want to continue to be of service to the community. And I want to help my kids reach their milestones in life. That’s what keeps me going – I’m a winner, not a quitter!”