‘For Me, Every Month is Breast Cancer Awareness Month’

For patients with metastatic breast cancer, the annual October observance of Breast Cancer Awareness Month can bring a complex mix of emotions.

“I think a lot of the messaging in October tends to focus on pink, and it almost looks a little sparkly,” said Sally Joy Wolf, who first received a diagnosis of breast cancer eight years ago before learning it had metastasized five years ago.

Wolf, to be clear, doesn’t think there is any malicious intent behind what she described as the “sea of pink” in October.

“I really like to believe that everyone who is trying to wait raise awareness or trying to do anything on behalf of anything, any cause, any cancer — but in my case, breast cancer — the intentions are good,” she said. “But there are many points in life where good intentions may not have the intended results simply because people don't have a level of intimate awareness that that comes from being on the inside.”

In the U.S., there will be an estimated 297,790 new cases of breast cancer, comprising 15.2% of all new cancer cases, and 43,170 deaths from breast cancer, or 7.1% of all cancer deaths, in 2023 among female patients with breast cancer, according to the National Cancer Institute, which also stated that metastatic breast cancer (cancer which has spread to other parts of the body and is also referred to as stage 4 breast cancer) has a five-year survival rate of 31%.

“For me, every month is Breast Cancer Awareness Month,” said Wolf. “Because I am dealing with an appointment or a scan, or medicine refill or an insurance mistake. So even though I am thriving, and really I am flourishing, and living a life that I love and I consider myself healthy … when I'm then looking out at a landscape where everything is pink … it's a little bit like a celebration of how far we've come, of how curable this is, of how early detection is great. And that's all true, decades of awareness have benefited all of us, including me because I'm on medicines that might not otherwise exist, but it's also easy for someone in my shoes to look at the month of October and feel like we don't quite fit. We're not celebrating being cured.”

Dr. Dawn Mussallem, a lifestyle medicine and integrative breast cancer specialist at the Robert and Monica Jacoby Center for Breast Health at the Mayo Clinic in Jacksonville, Florida, explained how she has observed the ways in which her patients with metastatic breast cancer have felt left out of the broader breast cancer community.

“When meeting these women for the first time, they share with me exactly what you are alluding to: the lack of supervised, positive support available for women with metastatic breast cancer, or a community they can belong to with other likeminded women going through the same thing,” Mussallem told CURE® via email. “The narrative shared with these women is different than for women with early-stage breast cancer.

“You see (for) women with early stage 1 to 3 breast cancer, the medical team informs them (that) cancer cure is likely/probable with appropriate treatment; however, women with metastatic breast cancer get told something no one should ever hear because it can, in some situations, dampen any sense of hope: ‘You have stage 4 breast cancer and this is something we can’t cure.’”

Mussallem, a cancer survivor as well as a bone marrow and heart transplant recipient, pushes back against such messaging.

“We can’t change the circumstances of a cancer diagnosis,” she said. “It isn’t going to just go away. Once it is there, it is there until it is gone. We can succumb to the diagnosis, or we can use it as a springboard of growth, an opportunity to look deeply inward and make each and every breath mean something bigger and better than we ever imagine. It is a shame it takes cancer to do this, but cancer is a magical teacher of life. There is no better way to embrace one’s aliveness then to hear those words, ‘You have cancer.’ I know because I am a 23-year stage 4 diffuse B cell non-Hodgkin lymphoma survivor. My cancer journey allows me to talk openly about the fear of dying and the glory of living now.”

Wolf, a longtime New York media executive, is now focused of advocating for wellbeing as a coach, advisor and speaker through LightWorks, where she is the founder and CEO.

“Sometimes it's a harder choice than others, but when we choose to see that light, even just like the tiny spark that may exist in a day, it is so helpful, because we come to realize that nothing is unilaterally light or dark or good or bad or all these labels we like to put on them and put on our lives as humans,” she said. “And even cancer, even in a metastatic cancer situation that I wish I weren’t in but I am, I can lean into meaning, lean into purpose, lean into gratitude and light. … ‘And I can say, this isn’t the life I expected to be leading. And yet, how grateful am I? How fortunate am I to get to live this life and get to make this impact with this card that I’ve been dealt?’ And I’m proud of how I’m playing it, so to speak.”

Wolf spoke with CURE’s “Cancer Horizons” podcast about her cancer journey so far, her life as a patient with metastatic breast cancer and the importance of life’s silver linings.

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