After having breast cancer for 34 years and undergoing treatment, Heather Cramer learned that she was cancer free. She dedicated herself to exercising regularly and eating healthy so she could enjoy life. But last year, she learned that she had breast cancer again. This time, it was triple negative, an aggressive form of cancer, and it had spread through her body, meaning it was metastatic.
“It’s scary,” said the 41-year-old from Maria Stein, Ohio TODAY. “It’s a tough road. I know they’re trying to say that breast cancer is more of a chronic disease, but it̵
The mother of three, wife and school treasurer make the most of every day and share her story to encourage others to visit the doctor if something seems wrong.
“Make sure you get checked,” she said. “If people feel like having a problem, go to the doctor right away.”
Breastfeeding reveals something wrong
After breastfeeding, her youngest son, Cramer, then 34, performed a self-examination of her breast, noting that her left breast did not feel right. When she went to the follow-up in October, she mentioned it to the doctor and asked for a mammogram. Her mother had a benign cyst removed from her breast when she was 34, and Cramer reckoned she experienced the same thing.
“He found a place that he was worried about, so he wanted them to check that area on a mammogram,” she said. “It was like a 50% chance it was cancer.”
Further tests revealed that she had invasive ductal carcinoma, a breast cancer that was estrogen and progesterone receptor positive, HER2 negative.
“I did not really have other risk factors. I did not have any of the genes for breast cancer, ”Cramer said. “I was not overweight. I cared for all my three children for a year. I trained. I started having children before the age of 30. I did not have my first period until I was 11 … I was quite surprised that I had cancer. ”
When she had her mastectomy in January 2014, they found the cancer spread to her lymph nodes. She underwent 16 weeks of chemotherapy, a bilateral mastectomy, reconstructive surgery and radiation. After treatment, scans showed no cancer and she enjoyed life without the invasive treatments and for frequent doctor visits.
“2015 to 2018 were good years where I didn’t really have anything going on,” she said.
She enjoyed spending time with her sons, now 13, 10 and 8, watching their sporting events or swimming with them. While she mostly felt healthy, she worked with a physiotherapist for problems with the irradiated tissue, tissue that was injured by radiation therapy. The therapist noticed two dents on her skin near an incision close to her armpit in late 2018.
“They were a bit like mosquito bites,” she explained. “I knew I was going to the doctor in February, so I just made them look at them back then.”
The doctor was not worried, so she resumed normal life. In April, however, it seemed that the bumps were abnormal. They did not go away, so she followed up with another doctor.
“I started freaking out,” she said. “They did another biopsy, and after a couple of weeks of trying to figure out what was going on, it came back as a triple negative breast cancer.”
When she had breast cancer at 34, 5% of it was triple negative, and doctors used treatment protocols for the larger percentage, estrogen and progesterone receptor cancer. The triple negative cancer returned and spread to the lungs, lymph nodes and brain.
“I was considered metastatic, stage 4,” she said.
Breast cancer in younger women is increasing
While most breast cancers are found in women who are 50 years or older, says Dr. Sagar Sardesai, Cramer’s treating oncologist that several younger patients are being diagnosed with it. According to the Centers for Disease Control and Prevention, about 11% of all new cases of breast cancer in the United States are found in women under 45 years of age.
“We are noticing an upward trend in younger women with a new breast cancer diagnosis, and the reason for this is not entirely clear so far,” the medical oncologist at the Ohio State University Comprehensive Cancer Center said today. “It has been linked to lifestyle factors that have to do with estrogen exposure.”
Women who have fewer children, have children after age 30, start menstruating before 11 and enter menopause later can all contribute to why doctors see increased breast cancer diagnoses in younger women, Sardesai noted.
“With all that, we see that estrogen exposure in a woman’s life has changed significantly and may be associated with the increased risk,” he said. “Other factors that appear to be increasing are related to genetics and family history.”
While Cramer said she did not have any of these risk factors, she was proactive in conducting breast examinations and talked to a doctor when she noticed that something was feeling out of place. Sardesai said women who observe differences in their breasts should talk to their doctor right away.
“I would say it is a very high priority,” Sardesai said. “It is very important for doctors to listen to their patients and not ignore their symptoms just because they are younger.”
When Cramer cancer returned, it looked like mosquito bites, and Sardesai said doctors should also remember that breast cancer does not always look one way.
“Breast cancer can occur in many ways. It’s not always just a lump. It can be a nipple discharge, soreness in the breast, changes in the skin, ”he said. “If it’s a young woman presenting some of these symptoms … they should not be dismissed.”
Life with metastatic breast cancer
Every day, Cramer wakes up and makes a spiritual devotion before showering for work.
“It’s like, ‘OK. It’s time to go. I have to get through this day for my kids and my husband, ” she said. “I do it for them.”
She still trains as much as she can and attends all of her son’s events. Some days the work feels hard, but she really loves her job.
“I do not want to wait to die. I think I would go crazy and not live my life still, ”she said.
Having a strong support system and a deep faith certainly helps her face chemotherapy and various radiation surgeries for tumors in the brain. It also does not hurt to cry in the closet when needed.
“I have my crying fits,” she said. “I think people with cancer should know that you also have the right to scream and cry and get it all out. I can not hold it all the time. ”
She hopes others understand that while it is difficult to have incurable cancer, it is not always gloomy.
“There is hope,” she said. “If you surround yourself with people who love you and build you up and keep you positive and pray for you and help you stay spiritually connected … it helps.”