Vaughn Smider, MD, PhD

Her voice was cracking. “I had … my digital … mammogram.”

“What?” I couldn’t have heard that right.

“They said … I have … cancer.” Her voice could barely speak the words. My head was starting to spin. I began to get chills and goose bumps, but tried to focus. I was out of town, but needed to do my best to be there for her. I thought quickly but this just didn’t make sense. Something wasn’t right.

“That can’t be right,” I said. “They need a biopsy to make a diagnosis of cancer.” Now my thoughts were racing. I was following my colleague who was pushing the button on an elevator. I had just given a research seminar at the University of Texas medical school in Houston, and was a long way from San Diego, where Elizabeth had to face this alone.

“If the connection drops, I’ll call right back. I’m getting in an elevator. But you need a biopsy to prove it’s cancer,” I said. 

In hindsight, that was pretty insensitive. My wife was telling me she had cancer, and I couldn’t postpone an elevator trip. But I didn’t believe she had cancer. Sure enough, the phone went dead. My colleague looked at me; it was obvious something was wrong.

“Well, not really. My wife has a lump in her breast.” This may have been the understatement of the century. She just told me she had cancer, but I didn’t believe it. To me, it was still a lump that could be anything: fibrous tissue, a cyst, a precancerous lesion. The elevator doors opened.

Outside, we waited to cross the street and I punched in her phone number. I looked up and printed in big letters on a tall building a block away was “M.D. Anderson Cancer Center.” How freaking ironic, I thought. 

“Hi, I’m sorry. We were in an elevator.”

“They said they’re about 95 percent sure,” she said, her voice a little more steady now.

She told me they had scheduled the biopsy for the next week. 

I didn’t sleep that night, but fell asleep on the flight back to San Diego the next morning. 

Over the next several weeks, our lives were embroiled in a series of tests: ultrasound, needle biopsy, MRI, PET scan. The biopsy of the breast was positive, and so was a lymph node under her armpit. Damn. That put her cancer at stage 3. The MRI and ultrasound showed at least five tumors in her left breast. Pathology showed the cancer was negative for estrogen, progesterone, and HER2 receptors. The tumor was “triple-negative”—one of the most aggressive subtypes of breast cancer that lacks the targets for effective drugs like tamoxifen and Herceptin (trastuzumab). This meant we were in for a battle.

Besides this, and worse yet, her tumor was “metaplastic,” which meant the tumor was forming lots of different types of cells. A handful of medical reports indicated it was a drug-resistant, rapidly growing, and rare variant.

This information caused a deep and painful sadness to swell in the pit of my stomach. Her cancer couldn’t be cured.

We traveled all over the country in hopes of finding the right clinical trial. Elizabeth started on more chemotherapy. First there was a response in her lungs, but at the same time there was more progression in her chest.

Although the tumor continued to grow, she was able to function remarkably normally. Many of her acquaintances had no idea what she was enduring. Interacting with her radiant personality on the outside gave no clues as to what was going on inside. 

Elizabeth began to feel out of breath on walks, but was able to play sports with our son and “dress-up” with our daughter. I got her a pink laptop for her birthday that November, and she used it to surf the web during chemotherapy. Still, her ability to function normally was decreasing. Through the two-year battle, there was a continual trend of a step or two forward, then a step or two back. In the last few months, they were mostly steps back. By Christmas of 2008 her lungs could no longer function, and she called her family in to have some last important words and hugs and kisses. On a rainy and cold Christmas Eve in northern California, she gently passed away surrounded by her family.

Elizabeth was always insightful, interesting, and loving. But the depth of her being grew immensely as she faced an ever sooner death. She prayed throughout each day. This gave her strength. She joked, played, loved, learned, and lived throughout this ordeal. Although she knew her long-term survival was unlikely, she refused to give in to the idea that the tumor would kill her soon. 

We learned to live and appreciate our marriage and our family, and to lock cancer away for moments or even days at a time.

As a couple we learned to cope with the anxiety of tests and what the results of those tests might mean. We found ways to speak simply, openly, and honestly to our two young children about very painful subjects. We learned to live and appreciate our marriage and our family, and to lock cancer away for moments or even days at a time.

Battling cancer had become a way of life for two years; it is hard to even imagine what our lives were like before cancer became an unwanted visitor. Our small children know what cancer is. Our youngest, at 4, does not remember Mommy with long hair, which was long, beautiful, dark, and alluring. As my family finds a new normal, we will live our lives with respect and honor for what my wife went through and what she taught us about life, and with loving memories of the happiness, joy, and inspiration she brought us.

Vaughn Smider founded the Elizabeth Smider Foundation (

) in 2009 to create awareness and fund research for rare breast cancers.  

After an initial response to chemotherapy, the cancer began to progress. It began to visibly involve the skin and was dubbed “inflammatory.” This tumor was nasty—really, really nasty. A mastectomy and reconstructive surgery were ultimately performed. Then came more chemotherapy, then radiation. 

Amazingly, she seemed to be tumor-free. We took a vacation, and our life was starting to seem more normal. But a couple months later, a PET scan found two small glowing masses in her chest wall (where her breast used to be) as well as several tiny metastatic lesions in her lungs. This information caused a deep and painful sadness to swell in the pit of my stomach. Her cancer couldn’t be cured.

“Vaughn, I have stage 4, triple-negative, inflammatory, metaplastic breast cancer. You know what that means, and my chances of making it are not good,” she once reminded me. While realistic, she wasn’t exactly right. These terms were so unstudied—so rare&mdash;that no one really knew what they meant. Despite our medical backgrounds (Elizabeth was an optometrist), contacts, and resources, we were in the dark. Somehow after several days of reading medical journals, tears, meaningful walks on the beach, and Internet searches, we dug up some glimmers of hope. 

Vaughn Smider, MD, PhD

Alongside My Wife

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