Joyce Watkins King has a story to tell. It’s not the usual breast cancer story. In fact, her story illustrates why pink October’s message of early detection is more complicated than it sounds.
In late February 2012, Joyce, an artist in Raleigh, North Carolina, noticed a sore, moveable lump under her arm. Mindful of a family history of breast cancer, she checked with her doctor. She had had a similar lump tested five years earlier that proved to be benign, so when her doctor told her that a sore lump is usually a good sign, she was reassured. Her doctor recommended that they watch the lump to see if it went away, but when it just grew larger and more sore, her doctor sent her to a surgeon.
When the surgeon removed the lump, the pathology report revealed that she had cancer. However, the pathologist was unable to determine the type of cancer. The doctors felt that Joyce’s cancer could have started almost anywhere in her body and spread to her lymph nodes. This situation is known in the cancer world as an “unknown primary.”
The reason an unknown primary can be especially dangerous is that different chemotherapy drugs are used for different types of cancer. Making an inaccurate guess about the type of cancer could cost Joyce her life. From late April to early June, Joyce underwent tests to try to determine the type of cancer that had caused her lump. Finally, a breast MRI found two tiny lumps in the upper right quadrant of her breast. Just two and eight millimeters, one of these tumors was the primary that had sent out the cancer cells causing the 1.2 centimeter lump under her arm.
So the good news was that treatment could begin with the correct drugs for breast cancer. The bad news was that months had passed, and the pathology report showed that the tumors were triple negative breast cancer, an aggressive form of breast cancer that responds best to chemotherapy and for which other drugs like Tamoxifen or Herceptin are useless. Despite the routine screening mammogram Joyce had six months before she found the lump under her arm, Joyce would not be a symbol of the benefits of early detection.
The next pages of Joyce’s story will sound familiar to other breast cancer patients and their families. Combo chemo in the form of Taxotere, Adriamycin, and Cytoxan took their toll with nausea and fatigue. Joyce fought back with acupuncture, art, prayer, and a fantastic support team of family, church members, and friends. She used the website CaringBridge to let people know what was happening and how they could help with rides to the doctor and meals. She became known for the stylish way she wore hats and scarves after she lost her hair. An article in a Raleigh magazine shows her in a fedora in front of her art materials.
By the fourth treatment the tumors were gone! Fortunately, her surgeons had used titanium markers, so that when it was time for surgery in November, she was able to have a lumpectomy instead of a mastectomy. Even though the tumors were no longer visible, it was important to get clean margins in the area where the tumor started.