by Elyse Wild • photography by Two Eagles Marcus & Valerie Dietsche
There is no right or wrong way to navigate breast cancer. Each year, more than a quarter of a million women in the United States are diagnosed with a form of breast cancer, while one in eight women will be diagnosed in their lifetime. Today here are more than 2.8 million breast cancer survivors living in the U.S.; that’s 2.8 million individuals traversing the strenuous path that lies before them, each step forward denoting progress toward the greatest of victories.
The average age of breast cancer diagnosis is 62. Tina Derusha and Jori Phillips are two Grand Rapids women who belong to an uncommon group of survivors: women under age 45.
No matter the variables, each journey begins the same way: with a phone call.
Two days after the second mammogram of her life, Tina Derusha, then 42, received a phone call from her doctor asking her to return for a follow-up scan. The median age of a breast cancer diagnosis is age 62, and Derusha was not immediately distressed.
“They saw some areas of concern and wanted to do a more thorough exam,” Derusha explained. “Generally speaking, they didn’t expect someone at my age to have any issues.”
After the second mammogram, Derusha waited in a room alone while the radiologist read the scan. Twenty minutes later, she was surprised and nervous to be told that doctors wanted to do an ultrasound. Upon completing the ultrasound, more and more people began filling the room, and it was then she knew something wasn’t right.
“Something in the room shifted,” she recalled. “There was a palpable tension.”
Derusha had a biopsy that afternoon, and so began an excruciating waiting period.
“I wanted to pack my bags, get in a car and drive somewhere and just leave,” she said.
On October 15, two days after her biopsy, Dursha received a call from her doctors to confirm their suspicion: She had breast cancer. She describes feeling a rush of panic and an anxious desire to answer one question: Why?
“I thought, ‘What did I do? What did I eat? What was I exposed to? What did I do wrong?’” she expressed. “It is anxiety from the word go. You are looking at anything and everything [for an explanation].”
Derusha was diagnosed with two types of breast cancer: Ductal Carcinoma in situ (DCIS), stage 0, grade 2 and Invasive Ductal Carcinoma (IDC) grade 2, which showed itself as a 6.3-centimeter tumor. Fifty to 75 percent of all breast cancer diagnoses are IDC.
“I didn’t anticipate it,” Tina Derusha expressed. “I mean, nobody does. I was really health conscious and fit. It really gob-smacked me.”
Derusha was scheduled to meet with a multi-specialty team made up of a breast surgeon, a radiation oncologist, a chemo oncologist, a health counselor, an attending physician and a genetic counselor. The team would work together to formulate and execute a plan that would result in the best possible outcome for her.
Derusha describes growing up in a family that emphasized a holistic approach to health, and she felt immediately hesitant about the treatment option that was laid before her.
“[The discussion] was chemo, right out of the gate,” she said. “I was adamant about avoiding it if I could. I wanted to know what my other options were based on what my diagnosis was that would do the most amount of repair with the least amount of damage.”
Since she decided to forgo chemotherapy, it was recommended that she have a mastectomy as soon as possible. Derusha’s surgery was scheduled one month and two days after her initial diagnosis, and she began the work of preparing her body for what was to come.
“I had four weeks to prepare myself to be as healthy as I could be and hopefully heal quicker,” she said.
Already a patient of Grand Rapids Natural Health, Derusha worked with her naturopathic doctor to give her body what it would need for a smooth recovery; she upped her supplements with an emphasis on zinc, A Vitamins, C Vitamins and probiotics. She also took up meditation, to help quiet the noise in her brain that is an inevitable burden of any cancer diagnosis and yoga, to build her strength.
“Yoga ended up being my lifeline through my surgeries and my recovery,” Derusha expressed. “It changed my life. I thought yoga was about getting physically stronger, but it is about getting mentally stronger, too.”
Taking care of her body in this way, she explains, helped her to make better choices regarding her treatment.
“No one prepares you for the deluge of information that comes at you,” she said. “You have to trust your inner voice.”
She also joined a young survivors group. Formed in 2013, the group is made of up women in their late 20s to mid-40s living with breast cancer. They meet at Lack’s Cancer Center at Mercy Health to share resources, talk and offer each other support. Derusha describes the group as tenaciously proactive.
“That group was instrumental in my healing,” Derusha explained. “In my mind, those are the people who are figuring out how to live and not how to die.”
After her mastectomy, she underwent occupational therapy to rebuild her range of motion, but her journey didn’t stop there: her cancer was estrogen positive, meaning it is fed by estrogen her body produces. Her options were to remove her ovaries, or have Zoladex injections once a month for ten years.
Zoladex is a medication that halts the production of estrogen, but it must be accompanied by medication to suppress the adrenal gland to prevent it from producing the hormone. After five months of injections, Derusha opted for surgery to remove her ovaries. During the time between her injections and the surgery, she endured 20 rounds of radiation.
Finally, one year after her diagnosis, in October of 2016, doctors told Derusha that her body showed “No Evidence of Disease,” a term used during the first five years of breast cancer recovery before doctors can definitively declare someone cured. She underwent reconstructive surgery, during which a tissue expander that was put in during her mastectomy was replaced with a permanent implant.
Derusha continues to practice meditation and yoga daily and celebrates her good health by connecting face-to-face with the people she loves most.
“I do a lot more inviting people over for dinner,” she said. “I just went sailing with a friend, and we had a blast. It was raining, I got water everywhere, I was laughing like a kid again— it was so nice.”
Throughout her journey, Derusha, a photographer by trade, did what came naturally to her: she created a photo series with local commercial photography Brian Kelly to reflect her experience.
“I wanted to document what it was like to feel normal pre-surgery, pre all of it, where at least from the outside, I appeared healthy,” she divulged. “I wanted to show how far I had come, and that you can still be beautiful on the other side of this, and that there is room in between those two for growth and beauty and connection with yourself.”
Jori Phillips decided to check with her doctor when she experienced abnormalities after breastfeeding her baby.
“One side deflated, and the other side felt like it was full of milk,” Phillips explained. “I said, ‘Let’s just get to the bottom of this and get a mammogram.’”
Her doctors performed a biopsy that day and removed cells from her breasts and lymph nodes to be analyzed.
A registered nurse and mother of four, Phillips spent a few hours researching breast cancer and then dedicated the next three days to enjoying her family while she waited for the call from her doctors.
“I knew my husband and I could very well not have a normal weekend for a long time,” she expressed. “We watched two really long movies, hung out with our kids, had a bonfire and just tried to relax. When they called, I knew what they were going to say.”
On February 25, 2013, four days after her biopsy, Phillips was diagnosed with HER2-positive, stage 4, grade 4 breast cancer. She was 35 years old. Fewer than five percent of women in the United States diagnosed with breast cancer are younger than 40.
HER2 is a protein that promotes the growth of cancer cells. Prior to current immunotherapy drugs, the survival rate for those with HER2-positive breast cancer was six months. The grade of cancer indicates how likely it is to grow and metastasize, one representing the lowest likelihood, with four being the highest. It has been said that breast cancer grows 17 times faster when women are pregnant or breastfeeding.
“I was crushed,” Phillips said. “I got into a mode of, ‘We will figure this out.’”
She put in her notice for leave from her job and began her fight. Her husband put up a Facebook group called, “Jori’s Fight Club.” Within days, one thousand people joined to keep up with her treatment and offers words of support. She also joined the young survivors group; the same one Derusha would join two years later. Here, she found a community of women embedded in research, fighting against the odds and steering through everyday life with cancer.
“It becomes your full-time job,” she said. “You research, you find out as much as you can.”
As Phillips began exploring her options for treatment, she had a nagging feeling that she needed to dig a little deeper. She asked her doctor do a full-body scan. After her first doctor denied her request, Phillips sought a second opinion and underwent a PET scan on her baby’s first birthday. She and her husband were preparing for her initial meeting with her multi-specialty care team when her doctor called with the results: The cancer was throughout her spine, the initial tumor was much larger than originally thought and there were four more tumors that were previously undetected.
Phillips describes feeling as though a bomb went off in her mind and her thoughts immediately went to her children, then ages 1-9.
“In that moment, a slide show played in my head of everything: their kindergarten graduations, grandchildren, weddings—I have three girls,” she expressed through tears. “I saw them growing up in slow motion.”
She met with her care team that evening and said, “Hit me with everything you’ve got. I don’t want to hear ‘comfort care.’ Do what you need to do to make
Phillips and her husband dove headfirst into adamantly researching everything they could about her type of cancer and the most effective options. Surgery and radiation are often not a part of the first round of treatment for stage 4 cancer. Phillips instead embarked on a targeted chemotherapy treatment. Her first and foremost concern through her journey was making sure she would have the capacity to be fully present with her family and care for her four children.
“I looked at my kids and said, ‘I am going to do whatever I can to be here for you as long as I can,’” she expressed. “I needed to do whatever I could to
She kept up her running routine and “overdosed on fruits and vegetables.” She also utilized the prayers and strength from others, fighting the natural instinct one feels with such a diagnosis to close up.
“You want to curl up and cry and shut down,” Phillips explained. “But you know you won’t have a good shot if you do that. I opened up and took help from people.”
She underwent a single mastectomy, and all the cancerous cells in her breast tissue were eliminated. Phillips was relieved, but her battle was far from over. A year into her treatment, she asked her doctors if they would do an MRI to be sure the cancer wasn’t spreading to her brain. Her request was met with something she had grown used to hearing: “That is not the standard of care.”
“You hear this a lot [when you are a cancer patient],” she said. “As a nurse and a patient, it frustrates me how stage 4 cancer is treated. There is so much more to be done to bring people the latest treatments, but we had to research on our own and advocate [for ourselves].”
Fortunately, her doctors performed an MRI, and low and behold, found a spot on her brain that indicated the cancer was spreading. The spot was treated with targeted radiation and has not returned since.
Phillips is now considered “disease stable,” which is defined by the National Cancer Institute as, “Cancer that is neither decreasing nor increasing in extent or severity.” She receives a weekly intravenous regimen of drugs that treat HER-2 positive breast cancer by jump-starting the body’s immune system and impairing HER-2 signaling.
The treatment has been effective and has given her reprieve from the emotional roller coaster that is cancer.
“Now, I have days where I don’t think about having cancer,” she smiled. “Something I have learned is just to be fully present and not think too far out. Being present and seeing things so clearly for the beautiful experiences that they are is something that has come from all of this.”
As Phillips describes her daughter recently being cast in the role of Belle in a school production of “Beauty and the Beast,” her joy radiates.
“Everything I go to for my kids is just the most amazing thing,” she expressed.
Phillips continues to eat with nutrition in mind and stays active by running two to three times per week, water skiing in the summertime and downhill skiing in the winter. This year, she and her husband are celebrating their 40th birthdays with a getaway to Aruba. In March, she returned to work for the first time since her diagnosis.
While Phillips and her husband both have medical backgrounds, she doesn’t want to give other survivors the impression that this gave her an advantage as they fought and advocated for treatments.
“People will say, ‘Well, you’re a nurse, and your husband is a physical therapist, and I wouldn’t be able to do what you did if it happened to me.’ But your will to survive is so strong. I say, ‘You would do this. Don’t underestimate yourself until you are faced with this.’”