The past few weeks have tested me physically, mentally, emotionally, and spiritually. The troll in my head—the one zapping me hundreds of times a day—finally quieted with medication, which I weaned off this week. At the same time, we met with my care team, and because of my reaction, they discussed skipping chemo altogether.
You'd think I'd be thrilled. Instead, I felt confused. My confidence was shaken.
A Shock to the Heart
When this journey began, I was adamant: remove Buella surgically and pursue a metabolic-only approach. But if you know me, you know I research e-v-e-r-y-t-h-i-n-g. I quickly discovered that while mice respond well to metabolic-only strategies, the human data isn't strong. Most studies combine metabolic therapies with standard treatments—chemotherapy, radiation, and, for tumors like mine, hormone therapy.
That meant my care team wasn't being overly cautious—they were following the science. Still, the sudden change in plan made me pause. Gavin laughed because just a month earlier, my doctor was trying to convince me I needed chemo. Now here I was, arguing for it. Why? Because in my research, I learned that premenopausal women with my markers—including the most aggressive tumor grade—do benefit from chemotherapy.
The doctor admitted the literature supports chemo for someone in my situation, but said we could pray about it and choose hormone therapy alone if we preferred. I left feeling like I had more control over my care than I should have. I know the patient is a significant part of the plan, but I felt a little shell-shocked because I am a Doctor of Education, not of Oncology. Nor would I ever want that job. It has to be so hard counseling people through this disease and playing a game of ratios and statistics. I realized there are worse things than having cancer: having cancer and losing confidence in yourself, your plan of care, and the care team because you don't understand their why.
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Prayer, Counsel, and A Port
So, we sought counsel. We prayed. We asked family closest to us, people who have walked this path, and other providers. All but one gave favorable responses to chemotherapy; therefore, we kept chemotherapy on the table. I informed the care team of my decision, and they placed a port in my chest to better withstand the medications coming. The procedure was fast, but the port has caused some restless nights of sleep due to the pain and discomfort. It is just another thing sewn into my chest wall between the tissue expanders and my collarbone. It's irritating but manageable and will hopefully be less sensitive once it heals.
Even after we decided to go with the chemotherapy, I still felt unsettled. I could not understand why there was such a drastic change of plan, and I was worried that I was pushing a treatment that doctors did not think I needed any longer. I felt the Holy Spirit nudging me to lean into this tension. That's when I pulled out the six questions from Andy Stanley's book Better Decisions, Fewer Regrets.
Questions I'm Asking to Make Decisions
The Integrity Question: Am I being honest with myself... really?
If I am honest, traveling across state lines for care—dealing with insurance and medication logistics—made me feel like I didn't matter outside the walls of the treatment facility. And while the team was kind in person, my confidence wavered when their communication failed after my first chemo, leaving me in pain and without support for days. They apologized for the lack of support provided and assured me it would not happen again. However, I know this colored the lens of future care in my eyes and in my heart.
The Legacy Question: What story do I want to tell?
I want to tell my kids and grandkids that I gave my best effort to eradicate this cancer—or at least die trying. I want to say to them that I believe Jesus was with me, and that He gave me a spirit of boldness to advocate with grace, humility, and wisdom.
The Conscience Question: Is there a tension that deserves my attention?
Yes. I've felt the tension of logistics and distance in my care, especially when it takes hours out of Gavin's weekly work schedule to drive me 3 hours round-trip for appointments. Thus, he works long hours without complaint, and does five days of work in four some weeks just so he can hold my hand at every appointment. Although he is adamant that I cannot choose care based on the hours in the car, I recognized this is one thing I can do for him if there is equally strong treatment available just a mile from home.
The Maturity Question: What is the wise thing to do?
Seeking a second opinion isn't disrespectful—it's wise. Not every patient fits every physician, and I believe the Great Physician was asking me to seek out another doctor to determine the best plan for our family.
The Relationship Question: What does love require of me?
Love requires that I fight for the best care, with grace and persistence, just as I would for Gavin or my children. My family will survive without me because they know Jesus, and they are strong and connected. However, I love them too much to give up by failing to advocate, research, or seek the treatment that best fits my situation.
The Kingdom Question: Where will my gifts have the most significant impact on the Kingdom?
Right here, in this season. God gave me the urge to write and share my story. If even one person comes to know His love and grace through it, then it is worth it.
A Second Opinion
We took a brave step and sought a second opinion this week. This new doctor specializes in breast cancer. She calls it her breast cancer lens. She was full of life, explained everything in detail, shared stories, even sketched a plan on the paper covering the exam bed, then copied my notes into my journal so I could take them home.
Her explanation was sobering but clear. Because of the aggressiveness of my cancer and my age, chemotherapy offers me an immediate and long-term benefit. Even a small gain, she explained, is like compound interest—it multiplies over time. Suppose I want to reduce recurrence by 25–30% over the next five years and increase overall survival by 15–20% over the next ten years. In that case, I need chemo added to the radiation + hormone therapy + ovarian suppression regimen. If I skip chemo, my high-risk features remain untreated systemically, and the risk of distant recurrence stays high.
Our new plan: four rounds of two drugs every two weeks, followed by twelve rounds of another drug weekly. That means instead of four rounds, I now face sixteen—and I have to start over. However, she promised to call a colleague at MD Anderson in Texas to confirm the plan and see if my first round could count toward the total.
She was honest, thorough, and real. She did say cold capping isn't very effective with this regimen—only about 16% of women retain 30–40% of their hair. However, hair loss is not permanent on this regimen, and she encouraged me by sharing stories of other women who had even thicker hair after chemotherapy.
The Hair Hits The Floor
The hair loss started happening this week, too. Even after nine hours of cold capping, my hair is falling out pretty heavily. My scalp aches, my follicles are inflamed, and after washing gently in cold water once this week, I cried as clumps fell away. Gavin came in as I was trying to regain composure from the pile that had accumulated in the sink, and he just held me and let me cry. Then he combed my hair so carefully with the cold-capping comb, as though each strand mattered. And it does. Not because I'm vain, but because this makes it real. The emotional struggle of hair loss is part of this journey, and with the help of Jesus and my family, I will learn to navigate it.
Shaving my head would probably be easier. But I'm not ready yet. However, when I start to feel fear rise—whether it's losing my hair, facing 16 rounds of chemo, or wondering if I made the right decision—I return to this promise:
"For God gave us a spirit not of fear but of power and love and self-control." —2 Timothy 1:7
This verse reminds me: fear doesn't get the final word. God has given me the strength to walk this road with courage, the love to fight for my family, and the self-control to advocate for what is wise.
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