By Elizabeth Allen
Dear Northern California,
I was just passing through and I wanted to thank you. Thank you for your doctors, artists, nurses and researchers, oh and your clam chowder, famous wine, windy ocean and magical forests.
I’ve always felt rather possessive of Northern California, and without any personal connection. In my early twenties I felt sure I would move here, having never even seen it (obviously never did). In my thirties I thought I might retire here, “maybe Petaluma,” I said confidently after a few days in wine country. I think now, it was a foreshadowing of this unforgettable interlude. Perhaps if this place hadn’t already called me for years, I might have missed a beautiful opportunity.
My visit is more specific than I implied. I came here to get a little help in healing my breast cancer, but I do so love to wax on poetically, I hope you didn’t mind.
I’m convalescing in a cabin in the redwoods in the Russian River Valley. All of my recent memories crowd for attention, but let me collect myself and start at the beginning.
I was laying in bed one night with my arm thrown across my chest when I realized my hand was perched on top of my breast like a little bird. I tapped it and it was hard. I tapped the other and it wasn’t. I felt alarm shoot through me. I decided I should just casually have a mammogram four years late and not mention it to my husband. Of course the tech saw micro-calcifications and a cascade of events unfolded.
I was sent to a breast clinic for an ultrasound/biopsy which landed me in a virtual meeting with a local surgeon who wanted to do a lumpectomy. It was too fast. I requested a physical exam which led to an MRI, which revealed a mass twice the size they had originally estimated… so she revised her plan to a mastectomy, which drove me to find a second opinion offering a complicated option, which borrowed me enough time to scour the internet for my diagnosis, ductal carcinoma in situ (DCIS).
Ductal carcinoma in situ is one of the most treatable/curable breast cancers, but mine had concerning characteristics. It was high-grade DCIS, I had a large (greater than 5 cm) palpable mass and abundant T-cell infiltration, it was hormone receptor negative (less than 1%) and Her2 positive, and I was diagnosed under age 45.
In DCIS, all roads of progress lead to Dr. Laura Esserman, the director of the Breast Care Center at UCSF. And so I came. She taught me to count chickens before they hatch, so you can always count them, and she convinced me that she’s possibly more curious than even I am.
Her curiosity has led her to the doors of those who hold the money to fund research. Her late-night phone calls with me were filled with all of the possible scenarios racing through her mind to find the key to the sometimes-miraculous cures with immunotherapy, and sometimes complete resistance. While my curiosity led me to her, it was no match for the curiosity that led her to head a research team with 20 interns, all racing to explore the viability of scenarios.
I do rather hope her children read this story and decide who will take one for the team and give her the grandchild she deserves… but I was overjoyed to become patient number 9 of 11 in the third arm of her clinical trial to treat DCIS with intratumoral immunotherapy injections (mRNA-2752). I made three quick trips to San Francisco and then one long trip after the trial to have surgery to remove and donate my tumor to research and get my dream “four babies later”: breast reduction.