Healthy Habits - A Mother Daughter Breast Cancer Story of Survival

 Merlise Diaz, 48, and her daughter, Leslie Grullon, 32, of Orange, NJ, were diagnosed with triple negative breast cancer and HER2-positive breast cancer three years apart and have no other confirmed family history of the disease. When Diaz received her stage two diagnosis at 44, genetic testing was performed to help guide treatment options. A negative test would lean toward standard options and a positive one might warrant additional drug therapy. Diaz’s tests were negative, meaning they showed normal findings with no gene mutations that increase the risk of breast cancer. Grullon and Diaz both felt relieved that the risk to Grullon would be less. But one day she discovered a strange lump while cleaning. This is their story. 

Diaz says her experience was surreal. She’s healthy otherwise and felt the cancer came out of nowhere. She had her physical in July of 2017 and everything came back normal. She thought she just had stress tension and went to see a chiropractor who had her doing stretches – it was doing a stretch that she found her cancer, which was between her left armpit and where her breast began. She was diagnosed in January 2018 and began chemo in February, which lasted six months. She had a lumpectomy and then took a cancer pill for one year. 

In January of 2021, her daughter who was only 29 at the time, was diagnosed with breast cancer.

Grullon said she experienced sharp pain while sweeping. The pain ran through her right shoulder to her left nipple, which is where the tumor was found. She massaged herself because of the pain and felt the lump. Her mom checked her out and felt the same lump. They went in for a diagnostic mammogram and she was diagnosed with HER2-positive stage three breast cancer. Looking back, she realized the extreme cold sweats she was having were an early symptom. Before that, she felt a small lump, but dismissed it because of the genetic testing. Grullon also tested negative for genetic breast cancer.

Both women wondered how they got breast cancer without confirmed family history and around the same time. They thought that the genetic testing results meant there wasn’t a hereditary trait to their disease. However, genetic testing, while beneficial in guiding cancer care, is still an evolving science and may not find every genetic link. The pair stressed the importance of testing, but also performing regular self exams, knowing your body, sharing all symptoms with your doctor, and advocating for your health. 

Mother and daughter both received treatment at HMH and are patients of Dr. Graham. Diaz had surgery, what she calls “top shelf” chemotherapy, and radiation. Grullon had AC (adriamycin and cyclophosphamide), a common chemotherapy regimen usually given for localized breast cancers. It is a combination of two chemotherapy medicines: Doxorubicin (Adriamycin) Cyclophosphamide (Cytoxan). She did that treatment for four rounds and then did a second level for eight weeks of PERJETA^® (pertuzumab), a prescription medicine approved for use in combination with Herceptin^® (trastuzumab) and docetaxel in people who have HER2-positive breast cancer that has spread to different parts of the body (metastatic). Grullon also had surgery, a double mastectomy. She had some benign fibroid findings in the right breast and the left breast was too small to save because of the tumor size. She had expanders put in to prepare her breast tissue for reconstructive surgery. She’s still wearing them a year and a half later because of an infection in her right breast that delayed the process. Grullon also had radiation treatment.

Mother and daughter both expressed how a positive mindset and good energy helped them heal. Grullon said watching her mother be strong through her process and see how treatment did not produce the side effects she imagined from the movies, gave her confidence to beat her breast cancer. They had knowledge about breast cancer the second time around and they said that made such a difference. They knew what to do, who to see, and what to expect. Awareness is key, she added.

I had a chance to learn more in this interview.

Can you share a little bit about how the experience of being diagnosed with breast cancer?

The experience was truly shocking, surreal and terrifying for the both of us. In my case I've always been pretty healthy and passed my yearly physical with flying colors just 6 months prior to diagnosis, so there was no reason to think there was anything wrong.  When Leslie was diagnosed it was an even bigger shock since the genetic test, I took upon diagnosis had come back clear and no harmful gene mutations for breast cancer were detected.  There was no sign that my cancer was linked to inherited factors so there was no reason to think Leslie would be in danger of developing breast cancer as well. And definitely not at 29-years old.  

How does genetic testing play a role in treatment options?

Genetic testing helps understand the risk of developing the disease in the future. For example, in the case of breast cancer when genetic testing discovers BRCA1 or BRCA2 mutations in the family it means some family members may carry a higher risk of developing breast or ovarian cancer in the future. Therefore, prompting earlier testing and preventive care. 

Why is it important to tailor treatment plans to the patient instead of a one-size-fits-all approach?

Unfortunately, one of the reasons why Cancer can be so challenging to treat is because everyone's type of Cancer is unique to their own body and level of tolerance for treatment. Factors like the type, the stage along with one's individual's health at time of diagnosis are all critical in treating the Cancer successfully. For example, someone with already established chronic illness like diabetes or heart disease might not be able to undergo the same treatment as someone who doesn't have those issues. Which is why a tailored approach is key to successful treatment.

How can alternative treatments be used to complement more conventional treatments?

I truly believe that in our case alternative treatments such as Meditation, Acupuncture and Reiki made a significant difference in both our physical and mental well-being both while going through treatment and after. For example, in my case since I was diagnosed with Stage 2 Triple Negative Breast Cancer (TNBC), a very aggressive type of breast cancer with lower survival rates and higher reoccurrence rates. My treatment options were limited to chemotherapy which would start with ACT (also known as Red Devil) followed by radiation and surgery. 

At the time of diagnosis my only reference to chemotherapy treatment were the images I had seen on TV shows and movies which were horrifying. Once I understood that chemo was my best option for survival, I made the decision to work with it and not "fight it".  I intentionally engaged my body affirming that my cells would work in harmony with the chemo to make the treatment and healing process as smooth as possible. I meditated on this frequently which alleviated a lot of fear and anxiety and prepared me for treatment physically, mentally and spiritually.  I was also lucky enough that the hospital offered Reiki services during treatment, and I truly believe that this not only helped calm my anxiety but enhanced my immune system and natural defenses to allowed for quick recovery after treatment and a peaceful experience overall. I experienced practically 0 side effects in the days following infusion treatments.

I was on chemo treatment for almost a year. Five months of scattered infusions and six months of taking 5 chemo pills a day. Once the chemo started accumulating in my body the only symptoms that ware not alleviated by meds were severe hot flashes that were brought on by early menopause and insomnia. For these I sought out Acupuncture and noticed drastic changes within the first couple of sessions . 

When Leslie was diagnosed, she followed the same meditation practice which helped alleviate her anxiety and stress levels as well. Unfortunately, due to covid restrictions Reiki wasn't available to her at the time of chemo treatments.  She experienced a lot more side effects to the infusion ttreatment than I did. Even landing in the hospital for a few days due to an infection. Obviously, I cant confirm that the 2 are correlated but I think things might have been a bit easier on her if she would've been able to pair the infusion sessions with Reiki.

 

Breast Cancer Facts in This Story:

HER2-positive Breast Cancer:

HER2-positive breast cancer is a breast cancer that tests positive for a protein called human epidermal growth factor receptor 2 (HER2). This protein is known to promote the growth of cancer cells. In about one of every five breast cancers, the cancer cells have extra copies of the gene that makes the HER2 protein. HER2-positive breast cancers tend to be more aggressive than other types of breast cancer.

Triple Negative Breast Cancer:

Triple-negative breast cancer (TNBC) accounts for about 10-15% of all breast cancers. The term triple-negative breast cancer refers to the fact that the cancer cells don’t have estrogen or progesterone receptors (ER or PR) and don’t make any or too much of the protein called HER2. (The cells test "negative" on all 3 tests.) These cancers tend to be more common in women younger than age 40, who are Black, or who have a BRCA1 mutation. 

TNBC differs from other types of invasive breast cancer in that it tends to grow and spread faster, has fewer treatment options, and tends to have a worse prognosis.

Genetic Testing:

Genes carry genetic coding and just as with other information in genes, mutations can be passed on from a parent to a child (inherited). Inherited gene mutations may also be called germline mutations.

For example, if a mother has a BRCA1 gene mutation, there’s a 50% chance her child will inherit the mutation and a 50% chance she won’t. The mother has two BRCA1 genes, one with a mutation and one with no mutation. The child gets one of your two BRCA1 genes from the mother and it’s random which copy. (The other BRCA1 gene from the father.)

What You Should Know:

It’s important to know that genetic testing can be an important piece of the breast cancer puzzle. However, it cannot replace self exams and routine screenings. Any time you notice a change in and around the breast tissue, it’s important to get it checked out right away.