Not All Warriors Carry Guns

From the Author 

You are a warrior within yourself. 

—Susan Richards

Without question, breast cancer is a disease that has a profound impact on life. It affects more than just the survivor; it causes a ripple effect on everyone who knows that survivor and provides a new perspective on life. This is a story of how breast cancer affected and impacted my family and our lives—a story of the challenges we faced, lessons we learned, and how we overcame them together on this journey.

For years, people said to me, You need to tell your story. To some extent, I’ve done that as a guest speaker at several breast cancer awareness and Relay for Life events and by being a mentor with the After Breast Cancer Diagnosis (ABCD) organization. Sometimes the pink survivor ribbon tattoo on my inner right wrist generates discussion in an elevator or checkout line at the grocery store. Although I simply share bits and pieces of my survivor story, people thank me and tell me that it can be an inspiration to others. 

With my journey, I’ve always said, I’m an open book because if sharing my story inspires one woman to do a breast self-exam or schedule her annual mammogram or helps one person on their journey by giving someone hope, then my journey will be proved worthwhile. I believe it’s all a part of God’s plan for me to carry the message. I believe everything happens for a reason and there are no coincidences. I’ve learned that there is more to telling my story than the words that come out of my mouth. 

My name is Melissa. I’m a daughter, a nurse, an Army veteran, a spouse to a career Army veteran, and a mother of two wonderful young adult children and a chocolate Labrador. I’m an athlete and a two-time breast cancer survivor!

First diagnosed at the age of thirty, I underwent several surgeries to remove the cancer with the end result of a mastectomy to remove my left breast. With a final diagnosis of extensive ductal carcinoma in situ (DCIS), my margins were negative by half a millimeter, meaning there were no cancer cells at the edge of the breast tissue. At the time, the doctors told me they had gotten it all, and that over the next five years I stood a four percent chance of my cancer coming back. Four days away from the golden five-year anniversary of being cancer-free, I received the shocking news the cancer had returned. When the cancer came back, it did so with a vengeance. This time, it spread to my lymph nodes under my left arm. Thirty of thirty-one lymph nodes proved malignant, meaning cancerous.

Treatment included surgeries as well as chemotherapy and radiation, and with those came the unwanted side effects.

To this day I still receive chemotherapy (chemo) treatment every three weeks. I have many lasting side effects from both chemo and radiation, one of which is lymphedema. 

Several times throughout my breast cancer journey, I’ve given thought to writing my story, but that’s as far as it went.

As you read the pages ahead, I hope you find this a compelling story of strength, hope, and courage. I share an intensely personal account of my journey and how I relied on my strong ideals, faith in God, and relentless passion to live. I wanted to watch my children grow up and meet all the important milestones in their lives and grow old with my college sweetheart and soul mate. Without question, the love I have for and from my family and the unwavering support of some of my closest friends lifted me up as I chose faith over fear.

I wouldn’t wish breast cancer on anyone, but during my journey I’ve learned valuable lessons that could prove beneficial to anyone, such as:

•It’s important to self-educate; knowledge is power.

•Be your own advocate; no one knows you better than you.

•Live life in the present; make the most of your time with your loved ones and try not to miss out on little moments if you can help it.

•Figure out your Why and hold onto it.

•Find your higher power and lean in. I couldn’t have gotten through this journey without God and the people he put in my path along the way. 

You need to read this book if: 

•You’ve received a diagnosis such as breast cancer or you’re someone going through a tragic life-changing event.

•You’re a loved one or family member of a breast cancer survivor.

•You’re a health care provider or caregiver. 

•You’re looking for an inspiring story of strength, hope, and courage.

•You’ve been touched by cancer or a tragic life-changing event.

Many times, people ask, Why me? I like to reframe that as, Why not me?

When diagnosed with breast cancer, I never asked, Why? I asked, What do I need to do? and How do I get through this? 

I discovered what I needed had been there all along: my inner warrior. My armor was choosing faith over fear and my Why.

Faith and blessings, 

Melissa

Facts and Tips for the Reader

Breast cancer remains the most commonly diagnosed cancer in women. One in eight women (13 percent) will be diagnosed with invasive breast cancer in their lifetime. The American Cancer Society estimates about 287,850 new cases of invasive breast cancer and 51,400 new cases of ductal carcinoma in situ will be diagnosed in women in the United States in 2022. The chance that a woman will die from breast cancer is about one in thirty (about 2.6 percent). Since 2007, breast cancer death rates have been steady in women younger than fifty but have continued to decrease in older women. Being a woman and growing older are both risk factors for developing breast cancer, but 4 percent of invasive breast cancer is diagnosed in women under the age of forty (breastcancer.org, 2022). While 4 percent might sound small, it isn’t zero. One in twenty-five women under the age of forty get diagnosed with invasive breast cancer (American Cancer Society, 2022). That was me! I was a 4-percenter! My initial diagnosis occurred at the young age of thirty, and then my second diagnosis hit me at a mere thirty-five.

Although the number of newly diagnosed cases might be high, the death rates have steadily dropped in women under age fifty since 2007. Thankfully, as a result of early detection and advancements in treatments and research, the overall death rates dropped by 1 percent per year from 2013 to 2018 (breastcancer.org, 2022). I firmly believe women of all ages should perform monthly breast self-exams (BSE) and if a woman finds something or has concerning symptoms or risk factors, she should bring it to her doctor’s attention. Self-advocacy remains imperative. Additionally, it’s important to get yearly mammograms, especially if there is a family history of a first-degree relative (mother, sister, or daughter) diagnosed with breast cancer under the age of forty.

We can’t change our sex or age, but there are steps we can take to reduce the risks of breast cancer. For example, maintaining a healthy weight is important since obesity increases the risks for developing breast cancer. Exercise and proper nutrition can improve overall health. One can benefit greatly by performing some form of aerobic activity for at least thirty minutes daily and consuming a diet high in vegetables and fiber but low in fat. Naturally, it’s important to consult with your doctor before starting any form of physical exercise. 

All breast cancer is not the same. Many variables come into play with a breast cancer diagnosis. A patient’s treatment plan will be based on the characteristics of the cancer and what treatment option best suits that patient. I believe it’s important for patients to educate themselves about the type of breast cancer they are diagnosed with. I always say, knowledge is power. And with that knowledge comes the power to make the best decision for treatment in collaboration with guidance from the doctors. Advocate and ask questions.¹

•What type of breast cancer do I have? 

•What treatment does the doctor recommend? 

•Why does the doctor recommend a particular course of treatment? 

If something isn’t clear, ask the doctor to explain it again. Be sure to understand and know the what and the why.

1 Please refer to the back of the book for a brief list of resources.

Chapter 1: 

How It All Began

You are a warrior within yourself. 

These six words inspired me to write my story.

One afternoon in December 2012, I arrived on the third floor at Walter Reed National Military Medical Center for chemotherapy. After checking in at the front desk, Eva, a nursing tech, checked my weight and my vitals before leading me back to the treatment room. As I entered the treatment room, I looked around the open bay for my usual nurse, Charlene Davis. Eva brought me over to one of the twenty reclining massage chairs, and as I placed my chemo bag on my chair, I looked at her and asked, Hey, Eva, where’s Charlene? 

She replied, Oh, she’s off, Mrs. O’Neil. You have Susan today. 

A petite blond-haired nurse walked over to my chair and cheerfully introduced herself as Susan Richards. Her pleasant disposition put me at ease.

As Susan prepared her supplies for accessing my port-a-cath, commonly referred to as a port, she asked, Do you mind sharing how they discovered your cancer? I began telling her a summary of my first diagnosis while we were stationed in Turkey. A port is a silicone disc that sits under the skin, usually on the right side of the chest. The port is attached to a catheter that is threaded into a large vein above the right side of your heart, also called the superior vena cava. It is used to draw blood and give treatments, such as chemotherapy, intravenous fluids, and other drugs (National Cancer Institute, 2022). 

As I shared, Susan busily took care of other patients, silencing pumps or hanging medications. During all this, she heard my story in bits and pieces. As I told her, she kept circling back wanting to hear more of the story.

She said, You have a story to tell. You need to write a book. This is a book I would definitely read. 

I replied, Really? How is my story so different?

Her answer, Your story is more than a journey with breast cancer. You would inspire so many people, Melissa. You are a warrior within yourself. 

This statement resonated with me. I decided that I needed to write my story.

My Story: 1997

Where do I even begin? My story begins with Anna Talerico, my grandmother, who was diagnosed with breast cancer in 1979 at the age of fifty-one. Back in the day, whenever people said the word cancer, it came out in a whisper, treated like a bad word you weren’t supposed to say. When she found the lump in her left breast, she ignored it, not wanting to do anything about it at first. She rationalized that it would go away and told herself not to worry about it. But that didn’t hold to be true. She basically had to be tricked into getting it checked out. According to my mom, She developed a cough and didn’t feel well, so we convinced her to go get the cough checked to rule out pneumonia.

At the appointment, Dr. Trevisani performed his examination and found the lump. My nana told him she found it four months earlier. Now larger and more pronounced with skin dimpling, he admitted her into the hospital that day. They performed a biopsy and confirmed the diagnosis of breast cancer. 

My mom recalled that she was angry with her sister for being late because it held my mom up. My mom wanted to quickly get to the hospital so when my nana came out of surgery, she wouldn’t be alone when the surgeon gave her the biopsy results. They arrived too late. Alone in her hospital room except for her roommate, my grandmother heard the news from the surgeon no one wants to hear: You have breast cancer. 

They took her into surgery the next morning and performed a left modified radical mastectomy. This is the removal of the entire breast, some of the lymph nodes under the arm, and the lining over the chest muscles; sometimes part of the chest wall muscle may also be removed (Brigham and Women’s Hospital, 2022). The final pathology report came back as invasive ductal carcinoma, meaning the cancer started in the milk ducts and spread to surrounding tissue outside of the duct. The estrogen and progesterone hormone receptor tests also came back positive. In a little over a month, my nana would turn fifty-two years old.

I grew up very close to my nana and all of my aunts and uncles. My mom, Cecelia, the oldest of nine kids, brought me to Nana’s house a lot. Only a year and a half older than me, my youngest aunt, Anna, and I were inseparable. We had a tight-knit family that relied heavily on each other, especially during this time of uncertainty.

When I think back to this time in my life, I remember Nana constantly in and out of the hospital. At one point, her admission lasted almost four months. She became very frail and thin from all the vomiting caused by the chemotherapy. Her skin looked very pale, and she had dark circles under her eyes.

I remember my uncles buying marijuana and my great aunts making pot brownies for her. One time, Anna and I came in from playing outside, and as we entered the kitchen, I smelled the aroma of warm, chocolaty brownies in the air. I saw the plate of them on the counter, and as I reached for one, my aunt grabbed the plate and snatched the brownie out my hand. She scolded, No, young lady. These are special brownies for your nana. Hands off. Nana didn’t eat much, and the marijuana helped with the nausea and the pain. 

Over the next couple of years, she had many doctor’s appointments and scans. In January 1980, the bone scan, which is a complete body X-ray used to locate any cancer in the bones, confirmed the cancer had spread to her spine. She started a chemotherapy called Tamoxifen, which treats estrogen-positive breast cancer. Another time, the scan showed a shadow on the liver, which lead to further testing. Again, it confirmed the cancer had metastasized to the liver. This time she started two new types of chemotherapy that I would become all too familiar with in years to come: Adriamycin, also known as the Red Devil (because of its red color and nasty side effects) and Cytoxan. 

It seemed like every time she had another test, my mom sat us down to tell us that the cancer had spread to another area. May 1981 became the last time we learned that the cancer had once again invaded her body. This time, it showed up in her hip. My mom cried as she shared the news with us, They found more cancer. It’s not looking good. As my mom told us this news, my eyes welled up with tears. Anna and I held each other as the flood gates opened. Anna just wanted her mom to make it to her sixteenth birthday, which fell on 14 November.

Before her final admission to the hospital, we were at the house a lot to visit. I remember her mostly in bed. I would walk down the hall to her bedroom, knock on the door, and quietly peek around it to ask if I could come in. With her hand, she would motion for me to come in and up on the bed. I would lie down next to her, and she would put her arm around me. During these visits, we would talk—well, I did most of the talking. I shared a lot of my hopes and dreams. During one of those talks, I told her I would become a nurse when I grew up.

I couldn’t stay too long, as she would tire easily. Before I would leave, I’d kiss her cheek, tell her I loved her, and leave, closing the door quietly behind me. My heart would ache, and most of the time I ended up crying because I knew I wouldn’t have many more of these moments. 

During her breast cancer journey, Nana eventually got to a point where she was suffering in pain most of the time. The cancer got so bad that she had to be admitted to the hospital. I recall going to the hospital with my mother, but Anna and I were not allowed in Nana’s room because her condition had worsened. The doctors had her on continuous IV pain medication, and she wouldn’t even know we were there. My mom wanted my last memories of Nana to be those moments I shared with her when I laid with her in her room. So, Anna and I would hang out together in the family waiting room doing homework or we would wander around the hospital and eventually head to the cafeteria. 

In my dream on the night of 17 November 1981, I came home from school and as I walked into my bedroom, my little sister blurted out, Nana died! What a nightmare. I knew Nana would die one day, just not this soon. The next morning, I arrived at school just wanting the school day done so I could go to the hospital and hope my mom would let me see Nana one more time so I could tell her I loved her.

When I got home from school that afternoon, my sister Cheryl said, Daddy wants to see you in the front room. As I started heading to the front room, I got a weird feeling in the pit of my stomach. My nightmare came to fruition. Just about halfway to the room, she blurted out, Nana died. I fell to the floor in disbelief, putting my face in my hands, screaming inside. My world just crumbled!

I hate cancer! I hate it!

Now that cancer had crept into our lives, the women in my family were told to be diligent in doing monthly breast self-exams. Most of the women in the family were very large-breasted, and luckily, I wasn’t one of those women. My mom and four aunts were checked and diagnosed with fibrocystic breast disease. The breast tissue feels lumpy or rope-like in texture. At my annual checkup with Dr. Trevisani, he told me that like all the other women in the family, I too had fibrocystic breast disease. Today, doctors now refer to this as fibrocystic breasts or fibrocystic changes because having fibrocystic breasts isn’t a disease (Mayo Clinic Staff, 2022).

Dr. Trevisani told me, Missy, I want you to do a monthly BSE; you need to know your lumps and bumps. Watch your caffeine intake and don’t smoke. 

He wanted me to watch for any changes and recommended I do my BSE the week after my period when my breasts would be