Eva Joseph: Keeping Breast Cancer at Bay with Immunotherapy

After I was diagnosed with stage 4 triple-negative breast cancer in July 2014, I was offered a place in a clinical trial testing a new treatment for exactly this type of cancer. I’ve been receiving regular infusions of an immunotherapy [atezolizumab; Tecentriq] and a chemotherapy [nab-paclitaxel; Abraxane] ever since, and the tumors in my lungs and sternum have shrunk dramatically. I don’t think they will ever be gone, but I feel good. My husband and I enjoy going out; one of our favorite things to do is take a picnic basket to one of the wineries around here.

It all started in March 2002, when I went for my annual mammogram. It showed two spots on my left breast, which were confirmed to be cancer after a biopsy. I was very scared, and I didn’t know what to expect. Was I going to die?

I first had a lumpectomy, but because the margins of the tissue around the cancer they removed were not clear of cancer cells, I had to have a mastectomy. During the surgery, they also removed the sentinel lymph node, which turned out to have cancer cells in it. This changed my diagnosis from stage 2 to stage 3, and the surgery was followed by chemotherapy and then radiation.

The side effects of the treatment were awful. I was nauseous all the time and so tired I could barely walk anywhere. I was also depressed because I thought I looked bad; I had lost my hair and gained weight from the steroids included as part of the treatment. One of the things that helped me recover from the emotional side effects of the chemotherapy was redesigning my garden. I just felt stronger when I was working in the garden, and transforming it was quite beautiful and life affirming.

Our life slowly returned to normal, but in 2014, I started experiencing tightness in my chest and difficulty breathing. My primary care physician thought it might be a problem with my heart, but an X-ray showed that I had a lot of fluid on my lungs. It also showed why the fluid was there; the breast cancer had metastasized to my lungs.

After liters of fluid were drained from my lungs, I had a series of scans to see if the cancer had spread anywhere else in my body. Unfortunately, it had; the bone scan showed tumors in my sternum.

I was devastated by this turn of events. I thought stage 4 breast cancer was a death sentence and that I was going to die imminently.

When I met with my oncologist to discuss my treatment plan, she recommended I enroll in the clinical trial testing an immunotherapy and chemotherapy combination as a treatment for patients with stage 4 triple-negative breast cancer. I felt that it was my best treatment option and began receiving atezolizumab and Abraxane shortly after. I’ve been on this combination of treatment ever since.

After several rounds of treatment, I began to feel stronger and scans showed that the tumors in my lungs and sternum were shrinking.

Today, I feel good. I do have some nausea from the treatment, but it is nothing like the severe sickness I felt during my first chemotherapy in 2002, and my husband and I are able to enjoy short trips, which we couldn’t back then. I wish I could say that the cancer is all gone, but I can’t; however, the tumors are very small and my treatment is keeping them at bay. Considering that people diagnosed with stage 4 triple-negative breast cancer are expected to live only about 18 months and I’m still here 4 years later, I’m doing very well.

I feel so fortunate to have had the opportunity to receive atezolizumab. I don’t think I would be here today and feeling this good without it.

I want people to know that this new immunotherapy is providing hope for people like me, people who thought they had no chance to live, and that it only came about because of cancer research and the hard work and money that supported it.